Pharmacokinetic profiles of boosted darunavir, dolutegravir and lamivudine in aging patients enrolled in the Swiss HIV Cohort Study

The pharmacokinetics (PK) of antiretroviral drugs may differ in elderly people living with HIV (PLWH) due to age related physiological changes. We aimed to assess the PK of several antiretroviral drugs in aging PLWH enrolled in the Swiss HIV Cohort (SHCS).; Full PK profiling nested in a multicenter, observational, prospective cohort study. Additional collection of single point PK data during SHCS follow-up visits (unselected PLWH).; PLWH were eligible for the full PK investigation if they were over the age of 55 years, on a stable boosted darunavir- or dolutegravir-containing regimen. Single point measurements were prospectively collected during SHCS follow-up visits to compare antiretroviral drug exposure in aging (≥ 65 years) and younger (< 65 years) PLWH.; Nineteen PLWH with a median age of 64 participated to the full PK investigations. Single point PK data were collected for 804 PLWH with a median age of 52. Boosted darunavir clearance was 40% lower in aging (≥ 65 years) compared to younger (< 65 years) PLWH, consistent with other drugs predominantly metabolized by CYP3A. Dolutegravir exposure was similar between age groups whereas lamivudine exposure increased by 11% in aging PLWH. Median boosted darunavir, dolutegravir and lamivudine t1/2 were 148%, 45% and 32% higher in aging compared to younger PLWH.; Advanced age did not affect boosted darunavir exposure to a clinically significant extent despite the observed high variability in exposure. Age minimally affected dolutegravir and lamivudine exposure. Thus, dose adjustment based on age is a priori not warranted.