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Although nucleoside reverse transcriptase inhibitors have been associated with lactic acidosis, lamivudine (3TC) has not been reported to have an increased risk with elevated concentrations. Therefore, some recommend that the lowest tablet strength of 3TC be considered in patients with kidney disease to avoid the inconvenience of liquid formations. Our institution avoids dose-adjusting 3TC until creatinine clearance (CrCl) <30 mL/min and uses 100–150-mg tablets daily in hemodialysis. The aim of this study was to describe the use of higher-than-recommended doses of 3TC in a real-world setting.

Blood samples were collected before and 0.5–1.5 hours after 3TC administration in HIV+ adults. Predose (C_min) and postdose (C_max) samples were measured by high-performance liquid chromatography. Physiologically based pharmacokinetic modeling …