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HIV Med. 2018 Mar;19(3):216-226. doi: 10.1111/hiv.12570. Epub 2017 Dec 1.

Management of drug interactions with direct-acting antivirals in Dutch HIV/hepatitis C virus-coinfected patients: adequate but not perfect.

Collaborators (297)

Prins JM, Kuijpers TW, Scherpbier HJ, van der Meer JTM, Wit FWMN, Godfried MH, van der Poll T, Nellen FJB, Geerlings SE, van Vugt M, Pajkrt D, Wiersinga WJ, Goorhuis A, Hovius JW, Bijsterveld MAH, van Eden J, van Hes AMH, Mutschelknauss M, Nobel HE, Pijnappel FJJ, Weijsenfeld AM, Jurriaans S, Back NKT, Zaaijer HL, Berkhout B, Cornelissen MTE, Schinkel CJ, Thomas XV, De Ruyter Ziekenhuis A, van den Berge M, Stegeman A, Baas S, Hage de Looff L, Wintermans B, Veenemans J, Ziekenhuis C, Pronk MJH, Ammerlaan HSM, de Munnik ES, van Beek E, Jansz AR, Tjhie J, Wegdam MCA, Deiman B, Scharnhorst V, Ziekenhuis ET, van Kasteren MEE, Brouwer AE, van Erve R, de Kruijf-van de Wiel BAFM, Keelan-Pfaf S, van der Ven B, Buiting AGM, Kabel PJ, Versteeg D, Kinderziekenhuis E, van der Plas A, van der Ende ME, Bax HI, van Gorp ECM, Nouwen JL, Schurink CAM, Verbon A, de Vries-Sluijs TEMS, Bassant N, van Beek JEA, Vriesde M, van Zonneveld LM, van den Berg-Cameron HJ, Bruinsma-Broekman FB, de Groot J, de Zeeuw-de Man M, Boucher CAB, Koopmans MPG, van Kampen JJA, Pas SD, Driessen GJA, van Rossum AMC, van der Knaap LC, Visser E, Branger J, Rijkeboer-Mes A, Duijf-van de Ven CJHM, Schippers EF, van Nieuwkoop C, van IJperen JM, Geilings J, van der Hut G, Franck PFH, van Eeden A, Brokking W, Groot M, Elsenburg LJM, Damen M, Kwa IS, Groeneveld PHP, Bouwhuis JW, van den Berg JF, van Hulzen AGW, van der Bliek GL, Bor PCJ, Bloembergen P, Wolfhagen MJHM, Ruijs GJHM, Kroon FP, de Boer MGJ, Jolink H, Vollaard AM, Dorama W, van Holten N, Claas ECJ, Wessels E, den Hollander JG, Pogany K, Roukens A, Kastelijns M, Smit JV, Smit E, Struik-Kalkman D, Tearno C, Bezemer M, van Niekerk T, Pontesilli O, Lowe SH, Oude Lashof AML, Posthouwer D, Ackens RP, Schippers J, Vergoossen R, Weijenberg-Maes B, van Loo IHM, Havenith TRA, Leyten EMS, Gelinck LBS, van Hartingsveld AY, Meerkerk C, Wildenbeest GS, Mutsaers JAEM, van Veen SQ, Slotervaart MC, Mulder JW, Vrouenraets SME, Lauw FN, van Broekhuizen MC, Paap H, Vlasblom DJ, Smits PHM, Zuiderzee MC, Weijer S, El Moussaoui R, Bosma AS, van Vonderen MGA, van Houte DPF, Kampschreur LM, Dijkstra K, Faber S, Weel J, Kootstra GJ, Delsing CE, van der Burg-van de Plas M, Heins H, Lucas E, Kortmann W, van Twillert G, Cohen Stuart JWT, Diederen BMW, Renckens R, Ruiter-Pronk D, van Truijen-Oud FA, van der Reijden WA, Jansen R, van den Berk GEL, Blok WL, Frissen PHJ, Lettinga KD, Schouten WEM, Veenstra J, Brouwer CJ, Geerders GF, Hoeksema K, Kleene MJ, van der Meché IB, Spelbrink M, Sulman H, Toonen AJM, Wijnands S, Kwa D, Witte E, van Crevel R, Keuter M, van der Ven AJAM, Ter Hofstede HJM, Albers M, Grintjes-Huisman KJT, Marneef M, Hairwassers A, Rahamat-Langendoen J, Burger D, Gisolf EH, Hassing RJ, Claassen M, Ter Beest G, van Bentum PHM, Langebeek N, Tiemessen R, Swanink CMA, van Lelyveld SFL, Soetekouw R, van der Prijt LMM, van der Swaluw J, Bermon N, Herpers BL, Veenendaal D, Verhagen DWM, van Wijk M, Bierman WFW, Bakker M, Kleinnijenhuis J, Kloeze E, Scholvinck H, Stienstra Y, Vermont CL, Wilting KR, Boonstra A, de Groot-de Jonge H, van der Meulen PA, de Weerd DA, Niesters HGM, van Leer-Buter CC, Knoester M, Hoepelman AIM, Barth RE, Bruns AHW, Ellerbroek PM, Mudrikova T, Oosterheert JJ, Schadd EM, Wassenberg MWM, van Zoelen MAD, Aarsman K, van Elst-Laurijssen DHM, van Oers-Hazelzet EEB, van Berkel M, Schuurman R, Verduyn-Lunel F, Wensing AMJ, Peters EJG, van Agtmael MA, Bomers M, de Vocht J, Heitmuller M, Laan LM, Ang CW, van Houdt R, Pettersson AM, Vandenbroucke-Grauls CMJE, Geelen SPM, Wolfs TFW, Bont LJ, Nauta N, Bezemer DO, van Sighem AI, Boender TS, Zaheri S, Hillebregt M, de Jong A, Bergsma D, de Lang A, Grivell S, Jansen A, Rademaker MJ, Raethke M, Meijering R, Schnörr S, de Groot L, van den Akker M, Bakker Y, Claessen E, El Berkaoui A, Koops J, Kruijne E, Lodewijk C, Munjishvili L, Peeck B, Ree C, Regtop R, Ruijs Y, Rutkens T, van de Sande L, Schoorl M, Timmerman A, Tuijn E, Veenenberg L, van der Vliet S, Wisse A, Woudstra T, Tuk B.

Author information

1
Department of Pharmacy, Radboud University Medical Center, Nijmegen, The Netherlands.
2
Radboud Institute of Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
3
HIV Monitoring Foundation, Amsterdam, The Netherlands.
4
Department of Pharmacy, University Medical Center Utrecht, Utrecht, The Netherlands.
5
Department of Internal Disease and Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands.
6
Department of Internal Medicine and Infectious Diseases, University Medical Center, Utrecht, The Netherlands.
7
Department of Internal Medicine and Infectious Diseases, OLVG, Amsterdam, The Netherlands.
8
Department of Internal Medicine and Infectious Diseases, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
9
Division of Infectious Diseases, Academic Medical Center, Amsterdam Infection and Immunity Institute, Amsterdam, The Netherlands.
10
Department of Global Health, Academic Medical Center of the University of Amsterdam, Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands.

Abstract

OBJECTIVES:

Direct-acting antivirals (DAAs) for treatment of chronic hepatitis C virus (HCV) infection can cause drug-drug interactions (DDIs) with combination antiretroviral therapy (cART) and non-cART co-medication. We mapped how physicians manage DDIs between DAAs and co-medication and analysed treatment outcomes.

METHODS:

Data were prospectively collected as part of the ATHENA HIV observational cohort and retrospectively analysed. Dutch patients with HIV/HCV coinfection who initiated treatment with DAAs between January 2015 and May 2016 were included. Co-medication 3 months prior to and during DAA therapy was identified. Potential DDIs with the DAAs were checked using http://hep-druginteractions.org. DDIs were categorized as: (1) no interaction expected; (2) potential interaction; (3) contra-indication; (4) no recommendation. These categories were used to determine which patients switched or had a DDI during DAA therapy with co-medication.

RESULTS:

A total of 423 patients were treated with DAAs, of whom 418 (99%) used cART and 251 (59%) used non-cART co-medication. Before commencing DAA treatment, in 17 of 84 (20%) patients the non-cART co-medication which could result in a category 2/3 DDI was discontinued before DAA initiation, including two of six (33%) prescriptions of category 3 drugs. A total of 196 of 418 (47%) patients had a category 2/3 DDI between their DAA regimen and cART. Category 2/3 DDIs were prevented by switching cART in 78 of 147 (53%) and 47 of 49 (98%) patients. Overall, 367 of 423 (87%) patients have achieved a sustained virological response (33 in follow-up).

CONCLUSIONS:

Prescription patterns suggest that physicians are aware of potential DDIs between co-medication and DAAs, in particular potential DDIs with cART. Greater awareness is needed concerning category 3 interactions between non-cART co-medication and DAAs.

KEYWORDS:

HIV; co-medication; combination antiretroviral therapy; direct-acting antivirals; drug-drug interactions; hepatitis C

PMID:
29194939
DOI:
10.1111/hiv.12570

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