Faculty Collaboration Database

Comparing the Frequencies of Contraindicated Drug-Drug Interactions Between Differing Antiretroviral Regimens in HIV-Infected Patients. Ann Pharmacother 2017 May;51(5):365-372

Date

04/04/2017

Pubmed ID

28367698

DOI

10.1177/1060028016685115

Scopus ID

2-s2.0-85017020529 (requires institutional sign-in at Scopus site)   17 Citations

Abstract

BACKGROUND: HIV-infected patients receiving antiretroviral therapy (ART) are at risk for contraindicated drug-drug interactions (XDDIs).

OBJECTIVE: This study compared the frequency of XDDIs between different types of ART regimens.

METHODS: A retrospective cohort study was performed among adult HIV-infected patients receiving care at either the Upstate New York Veterans' Healthcare Administration or the University of New Mexico Truman Health Services between 2000 and 2013. The cohort consisted of patients receiving traditional ART regimens composed of 2 nucleoside reverse transcriptase inhibitors plus either a nonnucleoside reverse transcriptase inhibitor (NNRTI), a protease inhibitor (PI), or an integrase strand transfer inhibitor (INSTI). The primary outcome was the presence of XDDIs. Lexi-Interact was used to define XDDIs.

RESULTS: Of the 1329 patients who met inclusion criteria, 45.7%, 34.2%, and 20.1% were receiving an NNRTI-, PI-, or INSTI- based ART regimen, respectively. Among the 128 (9.6%) patients with an XDDI, more than half (53.9%) had an interaction involving ART. The presence of XDDIs was highest for PI-based regimens (16.3%) compared with INSTI- (7.9%) and NNRTI-based (5.4%) regimens; P < 0.001. The variables independently associated with XDDIs were ART regimen type (prevalence ratio [PR] = 1.91; 95% CI = 1.51-2.40, P < 0.001), use of ≥6 non-HIV medications (PR = 5.84; 95% CI = 3.92-8.71, P < 0.001), and age ≥40 years (PR = 1.62; 95% CI = 0.92-2.86, P = 0.10).

CONCLUSION: The probability of XDDIs varies as a function of ART regimen type, advanced age, and use of multiple non-HIV medications.

Author List

Jakeman B, Nasiri M, Ruth L, Morse C, Mahatme S, Patel N

Author

Sheran Mahatme DO Associate Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Anti-HIV Agents
Antiretroviral Therapy, Highly Active
Contraindications
Drug Interactions
Drug-Related Side Effects and Adverse Reactions
Female
HIV Infections
Humans
Male
Middle Aged
Multivariate Analysis
New Mexico
New York
Regression Analysis
Retrospective Studies
Reverse Transcriptase Inhibitors
Young Adult