CREDID, Center for Research and Disruption of Infectious Diseases, Department of Infectious Diseases, Copenhagen University Hospital - Amager and Hvidovre, Hvidovre, Denmark.
Department of Infectious Diseases, Copenhagen University Hospital - Amager and Hvidovre, Hvidovre, Denmark.
HIV Med. 2023 Jan;24(1):46-54. doi: 10.1111/hiv.13321. Epub 2022 May 6.
Age-related comorbidities, polypharmacy and thereby the risk of potential drug-drug interactions (PDDIs) among people living with HIV (PLWH) have increased over the years. We estimated the prevalence of comedications, including dietary supplements, and evaluated PDDIs among PLWH receiving antiretroviral therapy (ART) in Denmark in an outpatient setting.
Information on prescription medication, over-the-counter medication and dietary supplements was obtained from adult PLWH receiving ART attending two outpatient clinics in Denmark. The PDDIs were identified using the University of Liverpool's drug interaction database. Associations between PDDIs and relevant variables were compared using logistic regression models.
A total of 337 PLWH receiving ART with a median age of 53 years (interquartile range: 45-61) were included; 77% were male and 96% had a HIV-RNA viral load < 50 copies/mL. Twenty-six per cent of participants received five or more comedications and 56% consumed dietary supplements. Co-administration of drugs requiring dose adjustment or monitoring was identified in the medication lists of 52% of participants, and 4.5% were on drugs that should not be co-administered. Male sex [odds ratio (OR) = 1.9, 95% confidence interval (CI): 1.0-3.4], being on a protease inhibitor (OR = 4.3, 95% CI: 1.9-9.7), receiving five or more comedications (OR = 3.3, 95% CI: 1.5-7.2), taking over-the-counter medications (OR = 1.9, 95% CI: 1.1-3.3) and dietary supplements (OR = 2.0, 95% CI: 1.2-3.3) were independent predictors of PDDIs.
Potential drug-drug interactions were common among our study population Our study confirms that polypharmacy and being on a protease inhibitor-based regimen increase the risk of PDDIs considerably and highlights the importance of questioning PLWH about dietary supplement intake.
随着时间的推移，与年龄相关的合并症、多种药物治疗以及由此产生的潜在药物相互作用（PDDI）在艾滋病毒感染者（PLWH）中不断增加。我们评估了丹麦门诊环境中接受抗逆转录病毒治疗（ART）的 PLWH 中包括膳食补充剂在内的合并用药的流行率，并评估了这些患者中的 PDDI。
从在丹麦两家门诊接受 ART 治疗的成年 PLWH 中获取处方药物、非处方药物和膳食补充剂的信息。使用利物浦大学的药物相互作用数据库识别 PDDI。使用逻辑回归模型比较 PDDI 与相关变量之间的关联。
共纳入 337 名接受 ART 治疗且中位年龄为 53 岁（四分位距：45-61）的 PLWH；77%为男性，96%的 HIV-RNA 病毒载量<50 拷贝/ml。26%的参与者接受了五种或更多种合并药物治疗，56%的参与者服用了膳食补充剂。在 52%的参与者的药物清单中发现了需要调整剂量或监测的药物联合使用，有 4.5%的参与者正在使用不应联合使用的药物。男性（比值比[OR] = 1.9，95%置信区间[CI]：1.0-3.4）、使用蛋白酶抑制剂（OR = 4.3，95%CI：1.9-9.7）、接受五种或更多种合并药物治疗（OR = 3.3，95%CI：1.5-7.2）、使用非处方药物（OR = 1.9，95%CI：1.1-3.3）和膳食补充剂（OR = 2.0，95%CI：1.2-3.3）是 PDDI 的独立预测因素。
在我们的研究人群中，潜在的药物相互作用很常见。我们的研究证实，多种药物治疗和使用基于蛋白酶抑制剂的方案会大大增加 PDDI 的风险，并强调了询问 PLWH 关于膳食补充剂摄入的重要性。
