The role of organic transporters in pharmacokinetics and nephrotoxicity of newer antiviral therapies for HIV and Hepatitis C

Highly active antiretroviral therapy (HAART) and direct acting antiviral agents (DAAs) are key elements in the effective pharmacotherapy of human immunodeficiency virus (HIV) and Hepatitis C virus (HCV) respectively. These two chronic illnesses affect millions of persons at any given time, though only a select proportion has been eligible for successful treatment. With the development of newer, safer and more effective antiviral therapies it is expected that a greater proportion of those infected will have access to these life-saving therapies. However, it is also important to appreciate that this very population will also be subject to increased toxicities from these agents. In this review we outline the published nephrotoxic effects of select new agents used in the management of HIV and HCV, specifically commenting, where possible, on the role of epithelial organic transporters in explaining the said renal toxicities.