Date of report: 02 Sep 2021

Reported case interaction between
Doravirine and Atorvastatin

83-year-old HIV patient with several revelant comorbidities (chronic kidney disease, stroke, cognitive impairment, Parkinson, diabetes mellitus) and relevant polypharmacy. He was on ART containing etravirine 200mg bid and raltegravir 400mg bid to avoid drug-drug interactions for several years, but he was taken a huge number of different pills. The patient requested a potential change in ARV regimen to reduce pill burden. ART was then modified to doravirine plus dolutegravir, which was expected to retain the same antiretroviral activity compared to previous regimen, and had a reduced number of daily pills. Although dose changes of the statine are not recommended, doravirine may decrease 33% of atrovastatine Cmax and also slightly the AUC; he was on low dose of atorvastatine (10mg), but this treatment was very relevant given his previous medical history. Three months after ART modification, HIV-1 viral load remained undetectable, cholesterol levels have not changed and the patient is very satisfied with the reduced pill burden of the ART regimen. Doravirine-dolutegravir combination is a promising high genetic barrier, sparring NRTIs, with low potential for relevant drug-drug interactions two-drug ARV combination. It could be an interesting ART regimen for older PLWH with polypharmacy and comorbidities.