Drug-Drug Interactions Between HIV Antivirals and Concomitant Drugs in HIV Patients: What We Know and What We Need to Know
Highly active antiretroviral therapy has led to a significant increase in the life expectancy of people living with HIV. The trade-off is that HIV-infected patients often suffer from comorbidities that require additional treatment, increasing the risk of Drug-Drug Interactions (DDIs), the clinical r...
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2024-12-01
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| author | Emanuela De Bellis Danilo Donnarumma Adele Zarrella Salvatore Maria Mazzeo Annarita Pagano Valentina Manzo Ines Mazza Francesco Sabbatino Graziamaria Corbi Pasquale Pagliano Amelia Filippelli Valeria Conti |
| author_facet | Emanuela De Bellis Danilo Donnarumma Adele Zarrella Salvatore Maria Mazzeo Annarita Pagano Valentina Manzo Ines Mazza Francesco Sabbatino Graziamaria Corbi Pasquale Pagliano Amelia Filippelli Valeria Conti |
| author_sort | Emanuela De Bellis |
| collection | DOAJ |
| description | Highly active antiretroviral therapy has led to a significant increase in the life expectancy of people living with HIV. The trade-off is that HIV-infected patients often suffer from comorbidities that require additional treatment, increasing the risk of Drug-Drug Interactions (DDIs), the clinical relevance of which has often not been determined during registration trials of the drugs involved. Therefore, it is important to identify potential clinically relevant DDIs in order to establish the most appropriate therapeutic approaches. This review aims to summarize and analyze data from studies published over the last two decades on DDI-related adverse clinical outcomes involving anti-HIV drugs and those used to treat comorbidities. Several studies have examined the pharmacokinetics and tolerability of different drug combinations. Protease inhibitors, followed by nonnucleoside reverse transcriptase inhibitors and integrase inhibitors have been recognized as the main players in DDIs with antivirals used to control co-infection, such as Hepatitis C virus, or with drugs commonly used to treat HIV comorbidities, such as lipid-lowering agents, proton pump inhibitors and anticancer drugs. However, the studies do not seem to be consistent with regard to sample size and follow-up, the drugs involved, or the results obtained. It should be noted that most of the available studies were conducted in healthy volunteers without being replicated in patients. This hampered the assessment of the clinical burden of DDIs and, consequently, the optimal pharmacological management of people living with HIV. |
| format | Article |
| id | doaj-art-c97b22ca707941ff972ed155f611f5df |
| institution | Kabale University |
| issn | 1999-4923 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Pharmaceutics |
| spelling | doaj-art-c97b22ca707941ff972ed155f611f5df2025-01-24T13:45:38ZengMDPI AGPharmaceutics1999-49232024-12-011713110.3390/pharmaceutics17010031Drug-Drug Interactions Between HIV Antivirals and Concomitant Drugs in HIV Patients: What We Know and What We Need to KnowEmanuela De Bellis0Danilo Donnarumma1Adele Zarrella2Salvatore Maria Mazzeo3Annarita Pagano4Valentina Manzo5Ines Mazza6Francesco Sabbatino7Graziamaria Corbi8Pasquale Pagliano9Amelia Filippelli10Valeria Conti11School “Clinical and Translational Oncology (CTO)”, Scuola Superiore Meridionale, University of Naples “Federico II”, 80138 Naples, ItalySchool “Clinical and Translational Oncology (CTO)”, Scuola Superiore Meridionale, University of Naples “Federico II”, 80138 Naples, ItalyPostgraduate School of Clinical Pharmacology and Toxicology, University of Salerno, 84081 Baronissi, ItalyPostgraduate School of Clinical Pharmacology and Toxicology, University of Salerno, 84081 Baronissi, ItalyPostgraduate School of Clinical Pharmacology and Toxicology, University of Salerno, 84081 Baronissi, ItalyClinical Pharmacology Unit, San Giovanni di Dio e Ruggi d’Aragona University Hospital, 84131 Salerno, ItalyPostgraduate School of Clinical Pharmacology and Toxicology, University of Salerno, 84081 Baronissi, ItalyDepartment of Medicine, Surgery, and Dentistry, Scuola Medica Salernitana, University of Salerno, 84081 Baronissi, ItalyDepartment of Translational Medical Sciences, University of Naples “Federico II”, 80131 Naples, ItalyDepartment of Medicine, Surgery, and Dentistry, Scuola Medica Salernitana, University of Salerno, 84081 Baronissi, ItalyClinical Pharmacology Unit, San Giovanni di Dio e Ruggi d’Aragona University Hospital, 84131 Salerno, ItalyClinical Pharmacology Unit, San Giovanni di Dio e Ruggi d’Aragona University Hospital, 84131 Salerno, ItalyHighly active antiretroviral therapy has led to a significant increase in the life expectancy of people living with HIV. The trade-off is that HIV-infected patients often suffer from comorbidities that require additional treatment, increasing the risk of Drug-Drug Interactions (DDIs), the clinical relevance of which has often not been determined during registration trials of the drugs involved. Therefore, it is important to identify potential clinically relevant DDIs in order to establish the most appropriate therapeutic approaches. This review aims to summarize and analyze data from studies published over the last two decades on DDI-related adverse clinical outcomes involving anti-HIV drugs and those used to treat comorbidities. Several studies have examined the pharmacokinetics and tolerability of different drug combinations. Protease inhibitors, followed by nonnucleoside reverse transcriptase inhibitors and integrase inhibitors have been recognized as the main players in DDIs with antivirals used to control co-infection, such as Hepatitis C virus, or with drugs commonly used to treat HIV comorbidities, such as lipid-lowering agents, proton pump inhibitors and anticancer drugs. However, the studies do not seem to be consistent with regard to sample size and follow-up, the drugs involved, or the results obtained. It should be noted that most of the available studies were conducted in healthy volunteers without being replicated in patients. This hampered the assessment of the clinical burden of DDIs and, consequently, the optimal pharmacological management of people living with HIV.https://www.mdpi.com/1999-4923/17/1/31HIVpeople living with HIVHAARTdrug-drug interactionspharmacokineticsadverse drug events |
| spellingShingle | Emanuela De Bellis Danilo Donnarumma Adele Zarrella Salvatore Maria Mazzeo Annarita Pagano Valentina Manzo Ines Mazza Francesco Sabbatino Graziamaria Corbi Pasquale Pagliano Amelia Filippelli Valeria Conti Drug-Drug Interactions Between HIV Antivirals and Concomitant Drugs in HIV Patients: What We Know and What We Need to Know Pharmaceutics HIV people living with HIV HAART drug-drug interactions pharmacokinetics adverse drug events |
| title | Drug-Drug Interactions Between HIV Antivirals and Concomitant Drugs in HIV Patients: What We Know and What We Need to Know |
| title_full | Drug-Drug Interactions Between HIV Antivirals and Concomitant Drugs in HIV Patients: What We Know and What We Need to Know |
| title_fullStr | Drug-Drug Interactions Between HIV Antivirals and Concomitant Drugs in HIV Patients: What We Know and What We Need to Know |
| title_full_unstemmed | Drug-Drug Interactions Between HIV Antivirals and Concomitant Drugs in HIV Patients: What We Know and What We Need to Know |
| title_short | Drug-Drug Interactions Between HIV Antivirals and Concomitant Drugs in HIV Patients: What We Know and What We Need to Know |
| title_sort | drug drug interactions between hiv antivirals and concomitant drugs in hiv patients what we know and what we need to know |
| topic | HIV people living with HIV HAART drug-drug interactions pharmacokinetics adverse drug events |
| url | https://www.mdpi.com/1999-4923/17/1/31 |
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