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Identification of potential clinically significant drug interactions in HIV ‐infected patients: a comprehensive therapeutic approach
Author(s) -
IniestaNavalón C,
FrancoMiguel JJ,
GascónCánovas JJ,
RenteroRedondo L
Publication year - 2015
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/hiv.12205
Subject(s) - medicine , identification (biology) , drug , human immunodeficiency virus (hiv) , pharmacology , computational biology , virology , botany , biology
Objectives The aim of the study was to determine the prevalence of potential clinically significant drug interactions ( CSDI s) in HIV‐positive individuals and to identify associated risk factors. Methods A cross‐sectional study was conducted including all HIV ‐infected out‐patients attending the Pharmacy Service of a regional reference hospital in Murcia, south‐eastern S pain. The complete treatment was screened for possible CSDI s using the Spanish College of Pharmacists' online software resource, bot . Additionally, the severity level of the CSDI s 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. Results Two 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 CSDI s, of which 52.9% involved ARV drugs. Seven therapeutic drug classes were involved in 75% of CSDI s (protease inhibitors, benzodiazepines, nonsteroidal anti‐inflammatory drugs, nonnucleoside reverse transcriptase inhibitors, corticosteroids, antithrombotics and proton pump inhibitors). Factors independently associated with CSDI s 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). Conclusions The 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.