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. 2020 Oct 18;7(11):ofaa416.
doi: 10.1093/ofid/ofaa416. eCollection 2020 Nov.

Evolution of Drug Interactions With Antiretroviral Medication in People With HIV

Majdouline El Moussaoui  1 , Iseult Lambert  1 , Nathalie Maes  2   3 , Anne-Sophie Sauvage  1 , Frédéric Frippiat  1 , Christelle Meuris  1 , Françoise Uurlings  1 , Marianne Lecomte  1 , Philippe Léonard  1 , Karine Fombellida  1 , Dolores Vaira  4 , Christelle Vercheval  5 , Michel Moutschen  1   4 , Gilles Darcis  1
Affiliations

Evolution of Drug Interactions With Antiretroviral Medication in People With HIV

Majdouline El Moussaoui et al. Open Forum Infect Dis. .

Abstract

Background: Polypharmacy and drug interactions are important issues for HIV-infected individuals. The number and nature of those interactions are continuously evolving with the use of new antiretroviral drugs and the aging of HIV-infected individuals. We aimed to analyze this evolution over time.

Methods: This retrospective cohort study was conducted in the University Hospital of Liège (Belgium). Treatments of HIV-infected outpatients attending Liège University Hospital were collected and analyzed in 2012 and 2016. The University of Liverpool HIV drug interactions database was used to determine drug interactions.

Results: We included 1038 patients in 2016, of whom 78% had 1 comedication. Polypharmacy was seen in 20% of the cohort. Four percent of the patients presented red flag interactions, and 38% had orange flag interactions. Nonantiretroviral (non-ARV) therapeutic classes involved in drug interactions were mostly cardiovascular and central nervous system drugs. They were followed by hormone drugs and dietary supplements for orange flag interactions. Two factors significantly contributed to both red and orange flag interactions: the number of non-ARV comedications and protease inhibitor-based ARV regimens. The proportion of patients with red or orange flag interactions remained stable from 2012 to 2016.

Conclusions: This study highlights the persistence of an alarming number of contraindicated drug interactions and a high prevalence of potential drug interactions over time. Identification, prevention, and management of drug interactions remain a key priority in HIV care.

Keywords: HIV; antiretroviral therapy; drug interactions.

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Figures

Figure 1.
Figure 1.
Independent risk factors for drug interactions in 2016. A, Red flag interactions. B, Orange flag interactions. Abbreviations: ARV, antiretroviral; INI, integrase inhibitor; NNRTI, non-nucleoside reverse transcriptase inhibitor; NRTI, nucleoside reverse transcriptase inhibitor; OR, odds ratio; PI, protease inhibitor.
See this image and copyright information in PMC

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