Brief Report: High Need to Switch cART or Comedication With the Initiation of DAAs in Elderly HIV/HCV-Coinfected Patients. (1st October 2017)

• Record Type: Journal Article
• Authors: Smolders, Elise J.; Smit, Colette; T. M. M. de Kanter, Clara; Dofferiiof, Anton S. M.; Arends, Joop E.; Brinkman, Kees; Rijnders, Bart; van der Valk, Marc; Reiss, Peter; Burger, David M.
• Is Part Of: Journal of acquired immune deficiency syndromes. Volume 76:Number 2(2017)
• Publication Date: 2017-10-01
• Subjects: cART -- comedication -- direct-acting antivirals -- drug–drug interactions -- hepatitis C -- HIV; AIDS (Disease) -- Periodicals; Acquired Immunodeficiency Syndrome -- Periodicals; AIDS (Disease); Periodicals; 616.9792005
• DOI: 10.1097/QAI.0000000000001488
• Languages: English
• ISSNs: 1525-4135

Abstract

Abstract : Background: To describe the use of nonantiretroviral comedication and combination antiretroviral therapy (cART) in patients coinfected with HIV/hepatitis C virus (HCV) and to predict the potential for drug–drug interactions (DDIs) with direct-acting antivirals (DAAs) against HCV. Methods: This is a retrospective, cross-sectional study, using the Dutch, nationwide ATHENA observational HIV cohort database. All patients with a known HIV/HCV coinfection on January 1, 2015, were included. Comedication and cART registered in the database were listed. The potential for DDIs between DAAs and comedication/cART were predicted usinghttp://hep-druginteractions.org . DDIs were categorized as: (1) no clinically relevant DDI; (2) possible DDI; (3) contraindication; or (4) no information available. Results: We included 777 patients of whom 488 (63%) used nonantiretroviral comedication. At risk for a category 2/3 DDI with nonantiretroviral comedications were 299 patients (38%). Most DDIs were predicted with paritaprevir/ritonavir, ombitasvir ± dasabuvir (47% of the drugs) and least with grazoprevir/elbasvir (11% of the drugs). Concerning cART, daclatasvir/sofosbuvir is the most favorable combination as no cART is contraindicated with this combination. In genotype 1/4 patients, grazoprevir/elbasvir is least favorable as 75% of the patients must alter their cART. Conclusions: This study showed that comedication use in the aging HIV/HCV population is frequent and diverse. There is a high potential for DDIs between DAAs and comedication/cART. Abstract : Supplemental Digital Content is Available in the Text.