抗逆转录病毒药物与 HIV 感染者女性中使用的其他药物相互作用的流行情况及其与 HIV 药物改变和患者依从性的关系。

The prevalence of antiretroviral drug interactions with other drugs used in women living with HIV and its association with HIV drug change and patient compliance.

机构信息

HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.

USERN Office, Fasa University of Medical Sciences, Fasa, 74616-86688, Iran.

出版信息

BMC Infect Dis. 2024 Oct 8;24(1):1123. doi: 10.1186/s12879-024-09958-x.

DOI:10.1186/s12879-024-09958-x

PMID:39379848

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11462963/

Abstract

BACKGROUND

Drug-drug interactions (DDIs) between antiretroviral therapy (ART) and commonly used co-medications in HIV patients, especially women, impact treatment efficacy and patient safety.

OBJECTIVE

This study aimed to study the prevalence and types of drug-drug interactions (DDIs) between antiretroviral therapy drugs (ARTs) and comedications among a female population with HIV. Additionally, the study investigates the association of these DDIs with ART medication changes and treatment adherence.

METHODS

This cross-sectional study included 632 adult women living with HIV (WLHIV). Data was retrospectively extracted from patient files. Drug.com interaction checker website was used to assess DDIs between ART and non-ART medications. Changes to the ART regimen previously attributed to ART side effects or patient non-adherence were considered drug changes.

RESULTS

A total of 429 WLHIV (mean age: 44.05 ± 9.50) were eligible. The prevalence of DDIs between ART and non-ART medications was 21.4%, with 4.7% minor, 18.4% moderate, and 8.9% major interactions. The highest prevalence of DDI was among cardiovascular medication users (71.7%), followed by central nervous system drugs (69.2%). Changing medications resulted in a decrease in DDIs, with significant reductions in total and minor interactions. Participants without DDIs had better adherence to ART. DDI between ART and non-ART medications was significantly associated with ART drug change, even after accounting for side effects attributed to ARTs, indicating an independent twofold association (OR = 1.99, CI 1.04-3.77). Moreover, further adjustments for HIV viral load and CD4 + cell count did not change the significance of the association (OR = 2.01, CI 1.03-3.92).

CONCLUSION

DDIs in WLHIV impact adherence to ART. Altering ART may not be directly related to ART side effects, but rather primarily due to interactions with non-ART medications. Modifying non-ART drug regimens can reduce the likelihood of DDIs.

摘要

背景

抗逆转录病毒疗法（ART）与 HIV 患者（尤其是女性）常用合并用药之间的药物相互作用（DDI）会影响治疗效果和患者安全。

目的

本研究旨在研究女性 HIV 人群中抗逆转录病毒治疗药物（ARTs）与合并用药之间药物相互作用（DDI）的流行率和类型。此外，还研究了这些 DDI 与 ART 药物改变和治疗依从性的关系。

方法

这项横断面研究纳入了 632 名成年女性 HIV 感染者（WLHIV）。数据从患者档案中回顾性提取。使用 Drug.com 相互作用检查器网站评估 ART 和非 ART 药物之间的 DDI。先前归因于 ART 副作用或患者不依从的 ART 方案改变被认为是药物改变。

结果

共有 429 名 WLHIV（平均年龄：44.05±9.50）符合条件。ART 和非 ART 药物之间 DDI 的发生率为 21.4%，其中轻度 4.7%，中度 18.4%，重度 8.9%。心血管药物使用者的 DDI 发生率最高（71.7%），其次是中枢神经系统药物（69.2%）。改变药物可降低 DDI，总 DDI 和轻度 DDI 显著减少。无 DDI 的参与者对 ART 的依从性更好。ART 和非 ART 药物之间的 DDI 与 ART 药物改变显著相关，即使考虑到归因于 ARTs 的副作用，这表明存在独立的两倍关联（OR=1.99，CI 1.04-3.77）。此外，进一步调整 HIV 病毒载量和 CD4+细胞计数并未改变该关联的显著性（OR=2.01，CI 1.03-3.92）。