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.
BMC Infect Dis. 2024 Oct 8;24(1):1123. doi: 10.1186/s12879-024-09958-x.
Drug-drug interactions (DDIs) between antiretroviral therapy (ART) and commonly used co-medications in HIV patients, especially women, impact treatment efficacy and patient safety.
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.
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.
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).
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.
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。
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。
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。
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）。
WLHIV 中的 DDI 会影响对 ART 的依从性。改变 ART 可能与 ART 副作用无关，而主要与非 ART 药物相互作用有关。改变非 ART 药物方案可降低 DDI 的可能性。
