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涉及抗逆转录病毒药物的药代动力学药物相互作用:最新进展

Pharmacokinetic Drug-Drug Interactions Involving Antiretroviral Agents: An Update.

作者信息

Yu Xin, Zhao Lifeng, Yuan Zheng, Li Yingfei

机构信息

Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, No. 16, Nanxiao Street, Dongzhimen Nei, Dongcheng District, Beijing, 100022, China.

出版信息

Curr Drug Metab. 2023;24(7):493-524. doi: 10.2174/1389200224666230418093139.

Abstract

Antiretroviral therapy is the recognized treatment for human immunodeficiency virus (HIV) infection involving several antiviral agents. Even though highly active antiretroviral therapy has been proven to be very effective in suppressing HIV replication, the antiretroviral drugs, belonging to different pharmacological classes, present quite complex pharmacokinetic properties such as extensive drug metabolism and transport by membrane-associated drug carriers. Moreover, due to uncomplications or complications in HIV-infected populations, an antiretroviralbased multiple-drug coadministration therapy strategy is usually applied for treatment effect, thus raising the possibility of drug-drug interactions between antiretroviral drugs and common drugs such as opioids, stains, and hormonal contraceptives. Herein, thirteen classical antiretroviral drugs approved by US Food and Drug Administration were summarized. Besides, relative drug metabolism enzymes and transporters known to interact with those antiretroviral drugs were detailed and described. Furthermore, one after the summarized antiretroviral drugs, the drug-drug interactions between two antiretroviral drugs or antiretroviral drug - conventional medical drugs of the past decade were discussed and summarized. This review is intended to deepen the pharmacological understanding of antiretroviral drugs and promote more secure clinical applications for antiretroviral drugs to treat HIV.

摘要

抗逆转录病毒疗法是公认的针对人类免疫缺陷病毒(HIV)感染的治疗方法,涉及多种抗病毒药物。尽管高效抗逆转录病毒疗法已被证明在抑制HIV复制方面非常有效,但属于不同药理类别的抗逆转录病毒药物具有相当复杂的药代动力学特性,如广泛的药物代谢以及通过膜相关药物载体进行转运。此外,由于HIV感染人群存在无并发症或有并发症的情况,基于抗逆转录病毒的多药联合给药治疗策略通常用于提高治疗效果,从而增加了抗逆转录病毒药物与阿片类药物、他汀类药物和激素避孕药等常用药物之间发生药物相互作用的可能性。在此,总结了美国食品药品监督管理局批准的13种经典抗逆转录病毒药物。此外,还详细介绍了已知与这些抗逆转录病毒药物相互作用的相关药物代谢酶和转运体。此外,在总结每种抗逆转录病毒药物之后,还讨论并总结了过去十年中两种抗逆转录病毒药物之间或抗逆转录病毒药物与传统药物之间的药物相互作用。本综述旨在加深对抗逆转录病毒药物药理作用的理解,并促进抗逆转录病毒药物在治疗HIV方面更安全的临床应用。

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