BETWEEN TACROLIMUS AND

AEGiS-12CROI: Management of Drug-to-drug Interactions between Tacrolimus and HAART HAART has improved the life expectancy of HIV-infected patients, allowing orthotopic liver transplantation to become a reasonable treatment option for selected patients with terminal liver disease. This study was designed to manage drug-to-drug interactions with immunosuppressive drugs such as tacrolimus and HAART. This study, included 10 HIV+ patients transplanted for end-stage chronic hepatitis C. Criteria for transplantation included: absence of opportunistic infection, CD4-cell count greater than 150 cells/ L, and undetectable HIV plasma viral load ( 50 copies/mL). HAART was stopped the same day of orthotopic liver transplantation and was reintroduced 10 days after. All patients received tacrolimus and prednisolone. Targets for tacrolimus blood concentrations were 8 to 20 ng/mL from day 0 until week 6, and 5 to 15 ng/mL after week 6. All patients received fluconazol 50 mg/day, trimetoprim / sulfametoxaxol, and ganciclovir. Tacrolimus pharmacockinetic parameters were calculated by non-compartmental method, in 8 of these patients on 2 occasions (period A) when liver function normalized (about 10 days post-transplantation), and (period B) 10 days after HAART reintroduction at standard doses (PI-nelfinavir n = 2, lopinavir/r n = 3, or NNRTI-efavirenz n = 2 + 2 nucleoside analogs) or 3 NRTI (n = 1). Doses of tacrolimus were individually adjusted according to tacrolimus trough blood concentrations.