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Evolution of Drug Interactions With Antiretroviral Medication in People With HIV.

ABSTRACT: Background:Polypharmacy and drug interactions are important issues for HIV-infected individuals. The number and nature of those interactions are continuously evolving with the use of new antiretroviral drugs and the aging of HIV-infected individuals. We aimed to analyze this evolution over time. Methods:This retrospective cohort study was conducted in the University Hospital of Liège (Belgium). Treatments of HIV-infected outpatients attending Liège University Hospital were collected and analyzed in 2012 and 2016. The University of Liverpool HIV drug interactions database was used to determine drug interactions. Results:We included 1038 patients in 2016, of whom 78% had 1 comedication. Polypharmacy was seen in 20% of the cohort. Four percent of the patients presented red flag interactions, and 38% had orange flag interactions. Nonantiretroviral (non-ARV) therapeutic classes involved in drug interactions were mostly cardiovascular and central nervous system drugs. They were followed by hormone drugs and dietary supplements for orange flag interactions. Two factors significantly contributed to both red and orange flag interactions: the number of non-ARV comedications and protease inhibitor-based ARV regimens. The proportion of patients with red or orange flag interactions remained stable from 2012 to 2016. Conclusions:This study highlights the persistence of an alarming number of contraindicated drug interactions and a high prevalence of potential drug interactions over time. Identification, prevention, and management of drug interactions remain a key priority in HIV care.

SUBMITTER: El Moussaoui M

PROVIDER: S-EPMC7651038 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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Evolution of Drug Interactions With Antiretroviral Medication in People With HIV.

El Moussaoui Majdouline M Lambert Iseult I Maes Nathalie N Sauvage Anne-Sophie AS Frippiat Frédéric F Meuris Christelle C Uurlings Françoise F Lecomte Marianne M Léonard Philippe P Fombellida Karine K Vaira Dolores D Vercheval Christelle C Moutschen Michel M Darcis Gilles G

Open forum infectious diseases 20201018 11

<h4>Background</h4>Polypharmacy and drug interactions are important issues for HIV-infected individuals. The number and nature of those interactions are continuously evolving with the use of new antiretroviral drugs and the aging of HIV-infected individuals. We aimed to analyze this evolution over time.<h4>Methods</h4>This retrospective cohort study was conducted in the University Hospital of Liège (Belgium). Treatments of HIV-infected outpatients attending Liège University Hospital were collect ...[more]

PMID: 33204748

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Project description:The incidence of depression is higher in PLWH (people living with HIV) than in the general population. It is of clinical significance to explore effective measures to improve depression in patients. But the available evidence is still quite limited. CBT (cognitive behavioral therapy) is considered to be one of the effective methods to improve depression, medication adherence and quality of life in PLWH. Therefore, this study aimed to systematically evaluate the effect of cognitive behavioral therapy on improving depressive symptoms and increasing adherence to antiretroviral therapy (ART) in people living with HIV (Human Immunodeficiency Virus). The Cochrane Library, Embase, PubMed, and Web of Science databases were searched by computer to collect randomized controlled trials on the effects of cognitive behavioral therapy on improving depression and increasing ART medication adherence in PLWH, and the retrieval time was from the inception of each database to January 10, 2022. Meta-analysis was performed by two researchers using Stata 15.0 software after screening the literature, extracting data and evaluating quality according to inclusion and exclusion criteria. A total of 16 studies with 1,998 patients were included. Meta-analysis results showed that CBT improved depressive symptoms in PLWH (SMD = −0.09, 95% CI [−0.13 to −0.04], P < 0.001) with better long-term (<6 months) depression improvement (SMD = −0.09, 95% CI [−0.15 to −0.02], P = 0.006) than short-term (0–6 months); the difference in improved ART medication adherence in the CBT group compared to the control group was not statistically significant (SMD = 0.04, 95% CI [−0.06 to 0.13], P = 0.490). There may be publication bias due to incomplete inclusion of literature as only published literature was searched. Cognitive behavioral therapy is effective in improving depressive symptoms in people living with HIV, with better long-term (>6 months) results than short-term (0–6 months).

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Evolution of Drug Interactions With Antiretroviral Medication in People With HIV.

Publications

Evolution of Drug Interactions With Antiretroviral Medication in People With HIV.

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