Prevalence of possible drugdrug interactions between antiretroviral agents in different age groups in a section of the private health care sector setting in South Africa

Katende-Kyenda, Norah L.; Lubbe, Martie S.; Serfontein, Jan H.P.; Truter, Ilse

doi:10.1111/j.1365-2710.2008.00930.x

Cited by 18 publications

(17 citation statements)

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“…However, no association was found between the presence of these interactions and virological failure 8 9. We also agree with other authors2 3 5 8 9 that the PIs are drugs most commonly involved in interactions, atazanavir being the most prevalent in our study.…”

Section: Discussionsupporting

confidence: 87%

Effect of drug interactions involving antiretroviral drugs on viral load in HIV population

et al. 2015

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BackgroundMost studies focus on potential drug interactions, without considering the effect of these on the response to antiretroviral (ARV) therapy. We assess the effect of potential drug–drug interactions (pDDIs) that could have lowered the ARV concentration (pDDI-lowerARV) on HIV viral load.MethodsRetrospective observational cohort study was conducted on all HIV-infected outpatients attending the Pharmacy Service of a regional reference hospital in Murcia (south-eastern Spain). The complete treatment was subsequently screened for pDDIs using the database ‘InteraccionesHIV.com’. The study focused on interactions involving at least one ARV drug and, especially, any pDDI-lowerARV.ResultsTwo hundred and twenty-nine patients were included in the study. A total of 168 pDDIs were identified, of which 62 (36.9%) had the potential to lower ARV concentrations. In 77% of cases, the drug involved in the reduction of plasma concentrations was a protease inhibitor (PI), and in the rest of the drug interactions the ARV drug affected was a non-nucleoside reverse-transcriptase inhibitor. Baseline viral suppression was noted in 57.1% of patients with pDDI-lowerARV compared with 61.5% of patients without pDDI-lowerARV (p=0.605), and in 85.7% versus 79.7%, respectively, after a 24-week follow-up period (p=0.516).ConclusionsThis study shows that prevalence of pDDI-lowerARV was high; however, no association was found between the presence of these interactions and virological failure. These results confirm the need for further studies to understand the consequences of interactions in real-life clinical practice, since most pharmacokinetic studies tend to evaluate the ability of interaction between two drugs under controlled conditions.

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Section: Discussionsupporting

confidence: 87%

Effect of drug interactions involving antiretroviral drugs on viral load in HIV population

et al. 2015

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“…It should be emphasized that this is the first study to examine drug interactions in HIV-infected patients from a holistic point of view, as most studies focus exclusively on interactions involving at least one ARV drug [3,5,7,23,24].…”

Section: Discussionmentioning

confidence: 99%

Identification of potential clinically significant drug interactions in HIV‐infected patients: a comprehensive therapeutic approach

et al. 2014

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ObjectivesThe aim of the study was to determine the prevalence of potential clinically significant drug interactions (CSDIs) in HIV-positive individuals and to identify associated risk factors. MethodsA cross-sectional study was conducted including all HIV-infected out-patients attending the Pharmacy Service of a regional reference hospital in Murcia, south-eastern Spain. The complete treatment was screened for possible CSDIs using the Spanish College of Pharmacists' online software resource, BOT. Additionally, the severity level of the CSDIs involving antiretroviral (ARV) drugs was compared with that established in the specific antiretroviral database InteraccionesHIV.com. Multivariate logistic regression was used to identify associated risk factors. ResultsTwo hundred and sixty-eight patients were included in the study. A total of 292 potential drug interactions were identified, of which 102 (34.9%) were CSDIs, of which 52.9% involved ARV drugs. Seven therapeutic drug classes were involved in 75% of CSDIs (protease inhibitors, benzodiazepines, nonsteroidal anti-inflammatory drugs, nonnucleoside reverse transcriptase inhibitors, corticosteroids, antithrombotics and proton pump inhibitors). Factors independently associated with CSDIs were treatment with more than five drugs [odds ratio (OR) 15.1; 95% confidence interval (CI) 6.3-36.2], and treatment with a protease inhibitor (OR 5.3; 95% CI 2.4-11.74). ConclusionsThe findings of this study suggest that the prevalence of clinically relevant drug−drug interactions is high in HIV-infected patients, and could represent a major health problem. Awareness, recognition and management of drug interactions are important in optimizing the pharmaceutical care of HIV-infected patients and helping to prevent adverse events and/or loss of efficacy of the drugs administered.Keywords: antiretroviral therapy, drug interactions, HIV, outpatient, risk factors Accepted 4 September 2014 IntroductionAs a result of improved antiretroviral therapy (ART), the expected lifespan of HIV-positive individuals has increased dramatically, but comorbidities such as cardiovascular disease, hyperlipidaemia, hypertension, diabetes, osteoporosis, renal disease and non-AIDS-related cancers are increasingly common [1]. Because of this comorbidity, a wide variety of drugs (e.g. antidepressives or antibacterials) are used alongside antiretroviral drugs. However, the combination of such drugs presents the potential for drug-drug interactions (DDIs), an important cause of adverse drug reactions (ADRs). . Several studies have suggested a positive correlation between increased age and increased risk for drug interactions in HIV-positive patients [5]. However, most studies focus on interactions involving at least one antiretroviral (ARV) drug and ignore those that involve non-ARV drugs, despite the fact that such drugs may be responsible for undesirable side effects, which may reduce adherence to treatment with a consequent decrease in effectiveness.The recognition and management of drug interactions are imp...

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“…6, 7 Drug-drug interactions are among the most prominent complications of HAART. 8 Simplifying HAART regimens to improve adherence has been a subject of tremendous research efforts and interests. 9, 10 Conceptually the simplest form of multi-target therapy would be a single structure compound inhibiting multiple viral targets.…”

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confidence: 99%

6-Benzoyl-3-hydroxypyrimidine-2,4-diones as dual inhibitors of HIV reverse transcriptase and integrase

Tang

Maddali

Dreis

et al. 2011

Bioorganic & Medicinal Chemistry Letters

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N-3-Hydroxylation of pyrimidine-2,4-diones was recently found to yield inhibitors of both HIV-1 reverse transcriptase (RT) and integrase (IN). An extended series of analogues featuring a benzoyl group at the C-6 position of the pyrimidine ring was synthesized. Through biochemical studies it was found that these new analogues are dually active against both RT and IN in low micromolar range. Antiviral assays confirmed that these new inhibitors are active against HIV-1 in cell culture at nanomolar to low micromolar range, further validating 3-hydroxypyrimidine-2,4-diones as a viable scaffold for antiviral development.

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Prevalence of possible drugdrug interactions between antiretroviral agents in different age groups in a section of the private health care sector setting in South Africa

Abstract: The importance of using drug utilization study as an identification tool to provide insight into the prescribing and utilization patterns of ARV drugs, to provide optimal therapy for patients infected with HIV is emphasized.

Cited by 18 publications

References 10 publications

Effect of drug interactions involving antiretroviral drugs on viral load in HIV population

Effect of drug interactions involving antiretroviral drugs on viral load in HIV population

Identification of potential clinically significant drug interactions in HIV‐infected patients: a comprehensive therapeutic approach

6-Benzoyl-3-hydroxypyrimidine-2,4-diones as dual inhibitors of HIV reverse transcriptase and integrase

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