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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.

Author information

1
*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.

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 using http://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.

PMID:
28902678
DOI:
10.1097/QAI.0000000000001488
[Indexed for MEDLINE]

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