Prevalence of Potential Drug–Drug Interactions in Patients of the Swiss HIV Cohort Study in the Era of HIV Integrase Inhibitors. (7th July 2020)

• Record Type: Journal Article
• Authors: Deutschmann, Elisabeth; Bucher, Heiner C; Jaeckel, Steffen; Gibbons, Sara; McAllister, Katie; Scherrer, Alexandra U; Braun, Dominique L; Cavassini, Matthias; Hachfeld, Anna; Calmy, Alexandra; Battegay, Manuel; Cipriani, Michela; Elzi, Luigia; Young, James; Lopez-Centeno, Beatriz; Berenguer, Juan; Khoo, Saye; Moffa, Giusi; Marzolini, Catia
• Is Part Of: Clinical infectious diseases. Volume 73:Number 7(2021)
• Page Start: e2145
• Page End: e2152
• Publication Date: 2020-07-07
• Subjects: HIV -- drug–drug interactions -- prevalence -- Swiss HIV Cohort Study -- modern antiretroviral therapy; Communicable diseases -- Periodicals; 616.905
• DOI: 10.1093/cid/ciaa918
• Languages: English
• ISSNs: 1058-4838

Abstract

Abstract: Background: Prevalence of potential drug–drug interactions (PDDIs) between antiretroviral drugs (ARVs) and co-medications was high in 2008 in a Swiss HIV Cohort Study (SHCS) survey. We reassessed the prevalence of PDDIs in the era of human immunodeficiency virus (HIV) integrase inhibitors (INIs), characterized by more favorable interaction profiles. Methods: The prevalence of PDDIs in treated HIV-positive individuals was assessed for the period 01–12/2018 by linkage of the Liverpool HIV drug interactions and SHCS databases. PDDIs were categorized as harmful (red flagged), of potential clinical relevance (amber flagged), or of weak clinical significance (yellow flagged). Results: In 9298 included individuals, median age was 51 years (IQR, 43–58), and 72% were males. Individuals received unboosted INIs (40%), boosted ARVs (30%), and nonnucleoside reverse transcriptase inhibitor (NNRTIs) (32%)–based regimens. In the entire cohort, 68% received ≥1 co-medication, 14% had polypharmacy (≥5 co-medications) and 29% had ≥1 PDDI. Among individuals with co-medication, the prevalence of combined amber and yellow PDDIs was 43% (33% amber—mostly with cardiovascular drugs—and 20% yellow-flagged PDDIs) compared to 59% in 2008. Two percent had red-flagged PDDIs (mostly with corticosteroids), the same as in the 2008 survey. Compared with 2008, fewer individuals received boosted ARVs (−24%) and NNRTIs (−13%) but the use of co-medications was higher. Conclusions: Prevalence of PDDIs was lower with more widespread use of INIs in 2018 than in 2008. Continued use of boosted regimens and increasing needs for co-medications in this aging population impeded lower rates of PDDIs. Abstract : Use of unboosted integrase inhibitors has reduced the prevalence of potential drug–drug interactions in swiss human immunodeficiency virus Cohort Study compared with 10 years ago, although to a lower extent than anticipated due to a higher use of co-medications as the human immunodeficiency virus population ages.