Chen Rong, Chen Jun, Tang Qi, Meng Zhihao, Luo Ling, Zhang Wei, Deng Aihua, Zhang Lukun, Wang Jiangrong, Qi Tangkai, Zhang Renfang, Shen Yinzhong, Liu Li, Steinhart Corky, Lu Hongzhou
Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.
Longtan Hospital of Guangxi Zhuang Autonomous Region, Liuzhou, Guangxi, China.
J Infect Chemother. 2020 Jul;26(7):722-728. doi: 10.1016/j.jiac.2020.04.003. Epub 2020 Apr 27.
Because people living with HIV (PLWH) are ageing, they will inevitably develop non-communicable diseases (NCDs) and the number of non-HIV medications will increase. Drug-drug interactions(DDIs) will become an ever-increasing issue. However, little is known about this important issue in Chinese PLWH. This study aimed to investigate the prevalence and risk factors of DDIs among PLWH in China.
Chinese PLWH aged ≥18 years were enrolled prospectively from October 2018 to April 2019 and after informed consent was obtained, they were ask to fill out a questionnaire about comorbidity and co-medications. Potential DDIs were identified using the University of Liverpool HIV Drug Interaction Checker.
A total of 1804 questionnaires were included. Antiretroviral drugs (ARVs) that most frequently were prescribed were lamivudine (96.18%), efavirenz(64.64%) and tenofovir(60.62%). 16.96% of the participations reported current co-infection with HIV and14.69% reported NCDs. 263(14.57%) participations reported they had used co-medications in the past six months while 186(10.31%) reported they were taking co-medications. Age≥50 years (p < 0.001), living in developed areas(p < 0.001) and lower CD4 cell count(p = 0.045) were independently associated with the use of co-medications. Potential DDIs were identified in 54 (19.15%) persons using co-medications. Age≥50 [OR = 2.272(1.241-4.158)], PLWH with NCDs[OR = 2.889(1.509-5.532)] and usage of protease inhibitors[OR = 2.538(1.250-5.156)] were independently associated with the potential DDIs.
The prevalence of the use of co-medications and potential DDIs among Chinese PLWH are low. Older age, NCDs and use of PIs were risk factors for the potential of developing DDIs. With the aging of PLWH, co-medications and DDIs in China warrants more attention.
由于感染艾滋病毒的人（PLWH）正在老龄化，他们将不可避免地患上非传染性疾病（NCDs），并且非艾滋病毒药物的数量将会增加。药物相互作用（DDIs）将成为一个日益严重的问题。然而，在中国的PLWH中，对于这个重要问题知之甚少。本研究旨在调查中国PLWH中药物相互作用的患病率及危险因素。
2018年10月至2019年4月前瞻性纳入年龄≥18岁的中国PLWH，在获得知情同意后，要求他们填写一份关于合并症和联合用药的问卷。使用利物浦大学艾滋病毒药物相互作用检查器识别潜在的药物相互作用。
共纳入1804份问卷。最常开具的抗逆转录病毒药物（ARVs）是拉米夫定（96.18%）、依非韦伦（64.64%）和替诺福韦（60.62%）。16.96%的参与者报告目前合并感染艾滋病毒，14.69%报告患有非传染性疾病。263名（14.57%）参与者报告他们在过去六个月中使用过联合用药，而186名（10.31%）报告他们正在服用联合用药。年龄≥50岁（p<0.001）、生活在发达地区（p<0.001）和较低的CD4细胞计数（p=0.045）与联合用药独立相关。在54名（19.15%）使用联合用药的人中识别出潜在的药物相互作用。年龄≥50岁[比值比（OR）=2.272（1.241-4.158）]、患有非传染性疾病的PLWH[OR=2.889（1.509-5.532）]和使用蛋白酶抑制剂[OR=2.538（1.250-5.156）]与潜在的药物相互作用独立相关。
中国PLWH中联合用药和潜在药物相互作用的患病率较低。年龄较大、患有非传染性疾病和使用蛋白酶抑制剂是发生潜在药物相互作用的危险因素。随着PLWH的老龄化，中国的联合用药和药物相互作用值得更多关注。
