Once-Daily Darunavir and the Brain

Once-daily dosing of darunavir is associated with lower drug concentrations in the cerebrospinal fluid than twice-daily dosing, but the clinical relevance of this observation remains unclear.

Darunavir is licensed for both once-daily and twice-daily dosing, but little is known about how these two dosing schedules affect penetration of darunavir across the blood–brain barrier. To address this issue, researchers studied a convenience sample of 41 HIV-infected patients who were receiving ritonavir-boosted darunavir and underwent lumbar puncture 2 to 28 hours after drug intake.

Thirty-eight patients had paired plasma and cerebrospinal fluid (CSF) samples available for analysis. CSF concentrations of darunavir were <1% of plasma drug concentrations; ritonavir, <0.1%. Compared with patients receiving twice-daily darunavir, those receiving once-daily doses had significantly lower CSF darunavir trough concentrations (median, 10.7 vs. 38.…

Reviewing Authors

Wajid Siddiqui, MD

Helmut Albrecht, MD

Disclosures

Grant / Research supportHealth Resources and Services Administration; Centers for Disease Control and Prevention

Leadership positions in professional societiesColumbia Medical Society; South Carolina Infectious Diseases Society

Helmut Albrecht, MD

Disclosures

Grant / Research supportHealth Resources and Services Administration; Centers for Disease Control and Prevention

Leadership positions in professional societiesColumbia Medical Society; South Carolina Infectious Diseases Society

Once-Daily Darunavir and the Brain

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Reviewing Authors