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A recent two-way drug–drug interaction study in healthy volunteers suggested that raltegravir and etravirine can be coadministered without dose adjustment (Antimicrob Agents Chemother 2008; 52:4228). Unfortunately, data from volunteer studies cannot always predict how these drugs will behave in HIV-positive individuals. No formal studies have been conducted to evaluate such interactions in patients with HIV infection.
The authors describe four patients treated with regimens containing both raltegravir and etravirine. One patient experienced a drastic decline of raltegravir plasma levels (from 313 ng/mL to 10 ng/mL), without any change in plasma levels of other antiretrovirals, when etravirine was added to the regimen. In the other three pati…