Table 1 PK studies assessing the interaction between HC and ARVs
PK studies assessing the interaction between DMPA and ARVs | |||||
|---|---|---|---|---|---|
| Â | Author | n | ARV | Hormones | Outcome |
1. | Cohn, Watts et al, 2006 (43, 44), pharma sponsored partly | 70 HIV+, 22-46 y | NFV (n = 21) EFV (n = 17) NVP (n = 16) NRTI only (n = 16) | DMPA, single dose | ↓ NFV ↑ NVP EFV - no significant change DMPA - no significant change Progesterone < 1.6 ng/ml, no ovulation Conclusion: DMPA is an effective contraceptive method for HIV+ women on ARVs in the study |
2. | Nanda et al., 2007 (45) | 30 HIV+, 19-40 y | AZT+3TC+EFV | DMPA, single dose | ARV levels - not done DMPA - no significant change Progesterone - only in one woman (control group) > 5 ng/ml, might indicate ovulation Conclusion: DMPA is an effective contraceptive method for HIV+ women on triple ARV regime in the study |
PK studies assessing the interaction between EE, progestins and NNRTIs and NtNRTI | |||||
1. | Mildvan et al., 2002 (46), pharma sponsored | 10 HIV+, 26-47 y | NVP 200 mg BID | 0.035 mg EE/1.0 mg NET, single dose | ↓ 29% AUC of EE ↓ 18% AUC of NET NVP - no significant change Conclusion: COC should not be primary method for contraception in HIV+ women on NVP |
2. | Joshi et al., 1998 (47), pharma sponsored | 13 HIV- | EFV 400 mg OD, 7 days | 0.05 mg EE, single dose | ↑ 37% AUC of EE EFV - no significant change Conclusion: no decrease in EE levels when co-administered with EFV |
3. | Sevinsky et al., 2008 (48), pharma sponsored | 28 HIV-, 18-42 y | EFV 600 mg OD, 14 days | EE/NGM, 3 cycles | EE - no significant change ↓ 64% AUC of NGMN ↓ 83% AUC of LNG EFV - no significant change Progesterone < 1.25 ng/ml Conclusion: need of reliable barrier contraception when taking COC with EFV |
4. | Scholler-Guyera et al., 2009 (49), pharma sponsored | 30 HIV-, 18-45 y | ETR 200 mg BID | 0.035 mg EE/1.0 mg NET, 3 cycles | ↑ 22% AUC of EE ↓ 5% AUC of NET ↑ ETR Conclusion: no compromise in contraceptive effect |
5. | Kearney et al., 2009 (50), pharma sponsored | 20 HIV-, 19-45 y | TDF 300 mg OD | EE/NGM, 3 cycles | EE - no significant change NGM - no significant change TDF - no significant change Conclusion: TDF does not alter PK of EE and NGM |
PK studies assessing the interaction between EE, progestins and PIs | |||||
1. | Ouellet et al., 1998(51), pharma sponsored | 23 HIV-, 18-45 y | Ritonavir 500 mg BID | 0.05 mg EE, single dose | ↓41% AUC of EE Conclusion: use an alternative contraceptive method when ritonavir is administered |
2. | Frohlich et al., 2004(54), pharma sponsored partly | 8 HIV-, 23.8 y | Saquinavir single dose | 0.03 mg EE 0.075 mg gestoden | SQV - no significant change Conclusion: COC does not alter single dose saquinavir |
3. | Tacket et al., 2003 (55), pharma sponsored | 22 HIV- | ATZ 400 mg | 0.035 mg EE/1.0 mg NET | ↑ 48% AUC of EE ↑110% AUC of NET Conclusion: no compromise in contraceptive effect, no dose adjustment needed |
4. | Sekar et al., 2008 (52), pharma sponsored | 19 HIV- | DRV/r 600 mg/100 mg BID | 0.035 mg EE/1.0 mg NET, 2 cycles | ↓44% AUC of EE ↓14% AUC of NET Conclusion: use an alternative method |
5. | Vogler et al., 2010 (53) | 8 HIV+ with LPV/r, 24 HIV+ w/o LPV/r | LPV/r 400 mg/100 mg | 0.035 mg EE/1.0 mg NET, single dose EE/NGMN skin patch for 3 w | ↓45% AUC of patch EE ↑83% AUC of patch NGNM ↓55% AUC of pill EE ↓19% AUC of LPV with patch ↓23% AUC of RTV with patch Progesterone < 2.88 ng/ml, no ovulation Conclusion: PK of EE/NGMN significantly altered, but clinical effect probably not affected |