[Correspondence] Itraconazole and antiretroviral therapy: strategies for empirical dosing – Author's reply

We thank Ilan S Schwartz and Sean Wasserman for their interest in our paper on the management of HIV-associated endemic mycoses.1 Schwartz and Wasserman rightly express concern regarding the known drug–drug interaction between itraconazole and non-nucleotide reverse transcriptase inhibitors (NNRTIs) efavirenz and nevirapine, which results in considerable reductions in plasma itraconazole concentrations following co-administration. NNRTIs are often included in standardised first-line antiretroviral therapy regimens in developing countries, and co-administration with itraconazole is commonly required during the consolidation and maintenance of therapy for histoplasmosis in Latin America and talaromycosis in Asia.

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