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Antimicrobial Agents and Chemotherapy, October 2001, p. 2902-2907, Vol. 45, No. 10
National Aids Therapy Evaluation Center,
Department of Internal Medicine, Division of Infectious Diseases,
Tropical Medicine and AIDS,1 and Center
for Reproductive Medicine, Department of Obstetrics and
Gynaecology,2 Academic Medical Center,
University of Amsterdam, and Department of Pharmacy and
Pharmacology, Slotervaart Hospital,3 Amsterdam,
The Netherlands
Received 29 December 2000/Returned for modification 26 April
2001/Accepted 21 July 2001
Limited data are available on antiretroviral drug concentrations in
seminal plasma during a dosing interval. Further, since human ejaculate
is composed of fluids originating from the testes, the seminal
vesicles, and the prostate, all having different physiological characteristics, drug concentrations in total seminal plasma do not
necessarily reflect concentrations in the separate compartments. Five
human immunodeficiency virus type 1-infected patients on nevirapine
(NVP; 200 mg twice a day [b.i.d.]) and/or indinavir (IDV; 800 mg
b.i.d. with ritonavir, 100 mg b.i.d.) regimens used a split ejaculate
technique to separate seminal plasma in two fractions, representing
fluids from the testes and prostate (first fraction) and fluids from
the seminal vesicles (second fraction). Split-ejaculate samples were
provided at 0, 2, 5, and 8 h after drug ingestion, on separate
days after 3 days of sexual abstinence. NVP and IDV showed
time-dependent concentrations in seminal plasma, with peak
concentrations in both fractions at 2 and 2 to 5 h, respectively,
after drug ingestion. The NVP concentrations were not significantly
different between the first and second fractions of the ejaculate at
all time points measured and were in the therapeutic range, except for
the predose concentration in two patients. The median (range) predose
IDV concentrations in the first and second fractions of the ejaculate
were 448 (353 to 1,015) ng/ml and 527 (240 to 849) ng/ml, respectively
(P = 0.7). In conclusion, NVP and IDV
concentrations in seminal plasma are dependent on the time after drug
ingestion. Furthermore, our data suggest that NVP and IDV achieve
therapeutic concentrations in both the testes and prostate and the
seminal vesicles throughout the dosing interval.
0066-4804/01/$04.00+0 DOI: 10.1128/AAC.45.10.2902-2907.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.
Pharmacokinetic Profiles of Nevirapine and
Indinavir in Various Fractions of Seminal Plasma
*
Corresponding author. Mailing address: Department of
Internal Medicine, Division of Infectious Diseases, Tropical Medicine and AIDS, Academic Medical Center, Room F4-217, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. Phone: 31-(0)20-5664479. Fax: 31-(0)20-6972286. E-mail: J.M.Prins{at}amc.uva.nl.
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