瑞士艾滋病毒队列研究患者在 HIV 整合酶抑制剂时代潜在药物相互作用的流行率。

Prevalence of Potential Drug-Drug Interactions in Patients of the Swiss HIV Cohort Study in the Era of HIV Integrase Inhibitors.

机构信息

Basel Institute for Clinical Epidemiology and Biostatistics, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland.

Division of Infectious Diseases and Hospital Hygiene, University Hospital Basel and University of Basel, Basel, Switzerland.

出版信息

Clin Infect Dis. 2021 Oct 5;73(7):e2145-e2152. doi: 10.1093/cid/ciaa918.

DOI:10.1093/cid/ciaa918

PMID:32634832

Abstract

BACKGROUND

Prevalence of potential drug-drug interactions (PDDIs) between antiretroviral drugs (ARVs) and co-medications was high in 2008 in a Swiss HIV Cohort Study (SHCS) survey. We reassessed the prevalence of PDDIs in the era of human immunodeficiency virus (HIV) integrase inhibitors (INIs), characterized by more favorable interaction profiles.

METHODS

The prevalence of PDDIs in treated HIV-positive individuals was assessed for the period 01-12/2018 by linkage of the Liverpool HIV drug interactions and SHCS databases. PDDIs were categorized as harmful (red flagged), of potential clinical relevance (amber flagged), or of weak clinical significance (yellow flagged).

RESULTS

In 9298 included individuals, median age was 51 years (IQR, 43-58), and 72% were males. Individuals received unboosted INIs (40%), boosted ARVs (30%), and nonnucleoside reverse transcriptase inhibitor (NNRTIs) (32%)-based regimens. In the entire cohort, 68% received ≥1 co-medication, 14% had polypharmacy (≥5 co-medications) and 29% had ≥1 PDDI. Among individuals with co-medication, the prevalence of combined amber and yellow PDDIs was 43% (33% amber-mostly with cardiovascular drugs-and 20% yellow-flagged PDDIs) compared to 59% in 2008. Two percent had red-flagged PDDIs (mostly with corticosteroids), the same as in the 2008 survey. Compared with 2008, fewer individuals received boosted ARVs (-24%) and NNRTIs (-13%) but the use of co-medications was higher.

CONCLUSIONS

Prevalence of PDDIs was lower with more widespread use of INIs in 2018 than in 2008. Continued use of boosted regimens and increasing needs for co-medications in this aging population impeded lower rates of PDDIs.

摘要

背景

在瑞士艾滋病毒队列研究（SHCS）调查中，2008 年抗逆转录病毒药物（ARV）与合并用药之间潜在药物相互作用（PDDI）的发生率很高。我们重新评估了人类免疫缺陷病毒（HIV）整合酶抑制剂（INIs）时代的 PDDI 发生率，其特征是相互作用谱更为有利。

方法

通过链接利物浦 HIV 药物相互作用和 SHCS 数据库，评估了 2018 年 1 月至 12 月期间治疗的 HIV 阳性个体中 PDDI 的发生率。将 PDDI 分为有害（红色标记）、有潜在临床相关性（琥珀色标记）或临床意义较弱（黄色标记）。

结果

在纳入的 9298 名个体中，中位年龄为 51 岁（IQR，43-58），72%为男性。个体接受了未增强的 INI（40%）、增强的 ARV（30%）和非核苷类逆转录酶抑制剂（NNRTI）（32%）为基础的方案。在整个队列中，68%的人接受了≥1 种合并用药，14%的人接受了多种药物治疗（≥5 种合并用药），29%的人存在≥1 种 PDDI。在接受合并用药的个体中，联合使用琥珀色和黄色 PDDI 的比例为 43%（琥珀色主要与心血管药物相关，占 33%，黄色 PDDI 占 20%），而 2008 年为 59%。有 2%的人存在红色标记的 PDDI（主要是与皮质类固醇），与 2008 年的调查相同。与 2008 年相比，接受增强型 ARV（-24%）和 NNRTI（-13%）的人数减少，但合并用药的使用量更高。