Emtricitabine Seminal Plasma and Blood Plasma Population Pharmacokinetics in HIV-Infected Men in the EVARIST ANRS-EP 49 Study

Author:

Valade Elodie,Tréluyer Jean-Marc,Illamola Silvia M.,Bouazza Naïm,Foissac Frantz,De Sousa Mendes Maïlys,Lui Gabrielle,Chenevier-Gobeaux Camille,Suzan-Monti Marie,Rouzioux Christine,Assoumou Lambert,Viard Jean-Paul,Hirt Déborah,Urien Saïk,Ghosn Jade

Abstract

ABSTRACTWe aimed to describe blood plasma (BP) and seminal plasma (SP) pharmacokinetics of emtricitabine (FTC) in HIV-1-infected men, assess its penetration in the male genital tract, and evaluate its impact on seminal plasma HIV load (spVL) detection. Men from the EVARIST ANRS EP49 study receiving combined antiretroviral therapy with FTC and with suppressed BP viral load were included in the study. A total of 236 and 209 FTC BP and SP concentrations, respectively, were available. A population pharmacokinetic model was developed with Monolix 4.1.4. The impact of FTC seminal exposure on spVL detection was explored by receiver operating characteristic (ROC) curves and mixed-effects logistic regressions. FTC BP pharmacokinetics was described by a two-compartment model. The addition of an effect compartment with different input and output constants best described FTC SP pharmacokinetics. No covariates were found to explain the variability in SP. FTC exposures (area under the concentration-time curve from 0 to 24 h [AUC0–24]) were higher in SP than in BP (median AUC0–24, 38.04 and 12.95 mg · liter−1· h, respectively). The median (range) SP-to-BP AUC0–24ratio was 2.91 (0.84 to 10.08). Less than 1% of FTC AUC0–24ratios were lower than 1. The impact of FTC SP AUC0–24or FTC SP-to-BP AUC0–24ratio on spVL detection was not significant (P= 0.943 or 0.893, respectively). This is the first population model describing FTC pharmacokinetics simultaneously in both BP and SP. FTC distributes well in the male genital tract with higher FTC concentrations in SP than in BP. FTC seminal plasma exposures were considered efficient in the majority of men.

Publisher

American Society for Microbiology

Subject

Infectious Diseases,Pharmacology (medical),Pharmacology

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