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Review
. 2023 Jul-Dec;19(11):795-806.
doi: 10.1080/17425255.2023.2267970. Epub 2023 Nov 17.

Drug-drug interactions between COVID-19 therapeutics and antiretroviral treatment: the evidence to date

Camden Ellis  1 , Keita Inaba  1 , Christine Van de Vuurst  1 , Atheel Ghrayeb  1 , Theodore James Cory  1
Affiliations
Review

Drug-drug interactions between COVID-19 therapeutics and antiretroviral treatment: the evidence to date

Camden Ellis et al. Expert Opin Drug Metab Toxicol. 2023 Jul-Dec.

Abstract

Introduction: With new effective treatments for SARS-CoV-2, patient outcomes have greatly improved. However, new medications bring a risk of drug interactions with other medications. People living with HIV (PLWH) are at particular risk for these interactions due to heightened risk of immunosuppression, polypharmacy, and overlap in affected organs. It is critical to identify drug interactions are a significant barrier to care for PLWH. Establishing a better understanding of the pharmacologic relationships between COVID-19 therapies and antiretrovirals will improve patient-centered care in COVID-19.

Areas covered: Potential drug-drug interactions between Human Immunodeficiency Virus (HIV) and COVID-19 treatments are detailed and reviewed here. The mechanisms seen in these interactions include alterations in metabolic enzymes, drug transporters, pharmacoenhancement, and organ toxicities. We also review the limitations and solutions that can be used to combat drug-drug interactions between these two disease states.

Expert opinion: While current drug interactions are relatively mild between HIV and COVID-19 therapies, improvements in identifying these beforehand must take place as new therapies are approved. Antiretroviral therapy (ART) is essential in PLWH and must be maintained when treating COVID-19. As advancements in care occur, there is the possibility that newly approved drugs may have additional unknown interactions.

Keywords: Antiretroviral; COVID-19; HIV; drug–drug interactions; pharmacokinetics.

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Conflict of interest statement

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

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