A retrospective study: Can dual ART mitigate the risk of potential drug-drug interactions among PLWH under stable ART?

Turk J Med Sci. 2023 Sep 17;53(5):1505-1511. doi: 10.55730/1300-0144.5718. eCollection 2023.

Abstract

Background/aim: People living with human immunodeficiency virus (PLWH) are getting older. Age-related comorbidities in PLWH result in polypharmacy and increase the risk for potential drug-drug interactions (pDDIs). This study aimed to evaluate how the rate of pDDIs would change if the treatment of patients receiving different combined antiretroviral therapies (ARTs) were theoretically changed with dolutegravir/lamivudine (DTG+3TC) or cabotegravir/rilpivirine (CAB+RPV).

Materials and methods: This study was conducted at the infectious disease outpatient clinic of a university hospital as a follow-up of a previous study. The data of PLWH receiving at least 1 comedication other than antiretrovirals (ARVs) were retrospectively reviewed and analyzed. The Drugs.com/Drug Interactions Checker and University of Liverpool HIV Drug Interactions Checker databases were used to identify pDDIs and their severities.

Results: A total of 75 PLWH, of whom 83% were male, with a mean age (± standard deviation) of 46.5 (±12.98) years were included. Polypharmacy was observed in 59 (79%) of the participants; however, with dual ARV options, the probability of polypharmacy was 35 (47%) (p < 0.001). In the Drugs.com database, no significant difference was found in terms of pDDIs between the treatment of current ARTs (64%) and DTG/3TC (%44) (p = 0.06) or CAB/RPV (%64) (p = 0.521). However, in the University of Liverpool database, the current rate of pDDIs (55%) was significantly higher compared to the theoretical treatment of DTG/3TC (40%) (p = 0.029), oral CAB/RPV (48%) (p = 0.003), and injectable CAB/RPV (31%) use (p = 0.006).

Conclusion: The results suggest that dual treatment regimens can reduce pDDIs, resulting in better tolerance and probably higher quality of life among PLWH.

Keywords: Antiretroviral; HIV; drug-drug interaction; dual therapy; polypharmacy.

MeSH terms

  • Adult
  • Anti-HIV Agents / adverse effects
  • Anti-HIV Agents / therapeutic use
  • Anti-Retroviral Agents / therapeutic use
  • Drug Interactions*
  • Drug Therapy, Combination
  • Female
  • HIV Infections* / drug therapy
  • Heterocyclic Compounds, 3-Ring / administration & dosage
  • Heterocyclic Compounds, 3-Ring / adverse effects
  • Heterocyclic Compounds, 3-Ring / therapeutic use
  • Humans
  • Lamivudine / administration & dosage
  • Lamivudine / therapeutic use
  • Male
  • Middle Aged
  • Oxazines / therapeutic use
  • Piperazines
  • Polypharmacy
  • Pyridones / administration & dosage
  • Pyridones / therapeutic use
  • Retrospective Studies

Substances

  • Anti-HIV Agents
  • Lamivudine
  • dolutegravir
  • Pyridones
  • Heterocyclic Compounds, 3-Ring
  • Oxazines
  • Anti-Retroviral Agents
  • Piperazines