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巴西贝洛奥里藏特传染病转诊中心接受治疗的 HIV 感染者的药物相互作用及对其抗逆转录病毒治疗效果的影响概况。

Profile of drug-drug interactions and impact on the effectiveness of antiretroviral therapy among patients living with HIV followed at an Infectious Diseases Referral Center in Belo Horizonte, Brazil.

机构信息

Universidade Federal de Minas Gerais (UFMG), Health Sciences: Infectology and Tropical Medicine, Faculdade de Medicina, Belo Horizonte, MG, Brazil.

Universidade Federal de Minas Gerais (UFMG), Health Sciences: Infectology and Tropical Medicine, Faculdade de Medicina, Belo Horizonte, MG, Brazil; Universidade Federal de Minas Gerais (UFMG), Faculdade de Medicina, Departamento de Medicina Interna, Belo Horizonte, MG, Brazil.

出版信息

Braz J Infect Dis. 2020 Mar-Apr;24(2):104-109. doi: 10.1016/j.bjid.2020.03.006. Epub 2020 Apr 29.

Abstract

HIV infection may be considered a chronic condition for people living with HIV with access to antiretrovirals and this has effectively increased survival. Moreover, this has also facilitated the emergence of other comorbidities increasing the risk for drug-drug interactions and polypharmacy. The profile of these interactions as well as their consequences for people living with HIV are still not completely elucidated. The objectives of this study were to describe the profile of these interactions, their prevalence and their classification according to the potential for significant or non-significant drug-drug interactions. From June 2015 to July 2016, people living with HIV on follow-up at an Infectious Diseases Referral Center in Belo Horizonte, Brazil have been investigated for the presence of drug-drug interactions. A total of 304 patients were included and the majority (75%) had less than 50 years of age, male (66.4%), and 37.8% self-defined as brown skinned. Approximately 24% were on five or more medications and half of them presented with drug-drug interactions. Patients older than 50 years had a higher frequency of antiretrovirals drug-drug interactions with other drugs compared to younger patients (p=0.002). No relationship was found between the number of drug-drug interactions and the effectiveness of antiretrovirals. As expected, the higher the number of non-HIV medications used (OR=1.129; 95%CI 1.004-1.209; p=0.04) was associated with an increase in drug-drug interactions. The high prevalence of drug-drug interactions found and the data collected should be useful to establish measures of quaternary prevention and to increase the medication security for people living with HIV.

摘要

HIV 感染可被视为接受抗逆转录病毒治疗的 HIV 感染者的慢性疾病,这有效地提高了存活率。此外,这也促成了其他合并症的出现,增加了药物相互作用和多药治疗的风险。这些相互作用的特征及其对 HIV 感染者的后果仍不完全清楚。本研究的目的是描述这些相互作用的特征、它们的流行程度以及根据药物相互作用的潜在意义进行分类。2015 年 6 月至 2016 年 7 月,巴西贝洛奥里藏特传染病转诊中心对接受随访的 HIV 感染者进行了药物相互作用的研究。共纳入 304 例患者,其中大多数(75%)年龄小于 50 岁,男性(66.4%),37.8%自我定义为棕色皮肤。约 24%的患者服用五种或更多种药物,其中一半存在药物相互作用。与年轻患者相比,50 岁以上的患者抗逆转录病毒药物与其他药物的相互作用频率更高(p=0.002)。抗逆转录病毒药物与其他药物的相互作用数量与抗逆转录病毒药物的效果之间未发现相关性。正如预期的那样,使用的非 HIV 药物数量越多(OR=1.129;95%CI 1.004-1.209;p=0.04),药物相互作用的增加越明显。发现药物相互作用的高流行率和收集的数据应有助于制定四级预防措施,并提高 HIV 感染者的药物安全性。

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