Addressing Antiretroviral Therapy‐Associated Drug‐Drug Interactions in Patients Requiring Treatment for Opportunistic Infections in Low‐Income and Resource‐Limited Settings. (8th September 2017)

• Record Type: Journal Article
• Authors: Chastain, Daniel B.; Franco‐Paredes, Carlos; Stover, Kayla R.
• Is Part Of: Journal of clinical pharmacology. Volume 57:Number 11(2017)
• Page Start: 1387
• Page End: 1399
• Publication Date: 2017-09-08
• Subjects: antiretroviral therapy -- drug‐drug interactions -- opportunistic infections -- HIV -- AIDS; Pharmacology -- Periodicals; Pharmacology -- Periodicals; Pharmacology, Clinical -- Periodicals; 615.1
• DOI: 10.1002/jcph.978
• Languages: English
• ISSNs: 0091-2700

Abstract

Abstract: An increasing number of human immunodeficiency virus (HIV)‐infected patients are achieving virologic suppression on antiretroviral therapy (ART) limiting the use of primary and secondary antimicrobial prophylaxis. However, in low‐income and resource‐limited settings, half of those infected with HIV are unaware of their diagnosis, and fewer than 50% of patients on ART achieve virologic suppression. Management of comorbidities and opportunistic infections among patients on ART may lead to inevitable drug‐drug interactions (DDIs) and even toxicities. Elderly patients, individuals with multiple comorbidities, those receiving complex ART, and patients living in low‐income settings experience higher rates of DDIs. Management of these cytochrome P450‐mediated, nonmediated, and drug transport system DDIs is critical in HIV‐infected patients, particularly those in resource‐limited settings with few options for ART. This article critically analyzes and provides recommendations to manage significant DDIs and drug toxicities in HIV‐infected patients receiving ART.