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J Acquir Immune Defic Syndr. 2017 Oct 1;76(2):193-199. doi: 10.1097/QAI.0000000000001488.

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

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*Department of Pharmacy, Radboud Institute of Health Sciences (RIHS) and Radboud university medical center, Nijmegen, the Netherlands; †HIV Monitoring Foundation, Amsterdam, the Netherlands; ‡Department of Pharmacy, University Medical Center Utrecht, Utrecht, the Netherlands; §Department of Internal Disease and Infectious Diseases, Radboud university medical center, Nijmegen, the Netherlands; ‖Department of Internal Medicine and Infectious Diseases, University Medical Center, Utrecht, the Netherlands; ¶Department of Internal Medicine and Infectious Diseases, OLVG, Amsterdam, the Netherlands; #Department of Internal Medicine and Infectious Diseases, Erasmus MC University Medical Center, Rotterdam, the Netherlands; **Academic Medical Center, Division of Infectious Diseases, and Center for Infection and Immunity Amsterdam (CINIMA), Amsterdam, the Netherlands; and ††Department of Global Health and Amsterdam Institute for Global Health and Development, Academic Medical Center of the University of Amsterdam, Amsterdam, the Netherlands.



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.


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 using DDIs were categorized as: (1) no clinically relevant DDI; (2) possible DDI; (3) contraindication; or (4) no information available.


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.


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.

[Indexed for MEDLINE]

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