Drug Interaction Consideration in HIV/HCV Coinfected Patients

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Uraiwan Akanit

Abstract

Nowadays the direct-acting antivirals (DAAs) are in Thailand National List of Essential Medicines (NLEM) for chronic hepatitis C virus (HCV) infection, which results in a more than 95% cure rate. Thus, most hepatitis C patients can now be cured. Patients with HIV/HCV coinfection have a higher mortality risk than Human Immunodeficiency Virus (HIV) infected patients without HCV infections. HIV and HCV coinfected patients require both antiretroviral therapy and antiviral treatment simultaneously. However, health care providers should aware of potential drug interactions among antiretrovirals and antiviral agents in the treatment of HIV and HCV coinfection. The main mechanism of drug interactions occurs during the metabolism process via cytochrome P450 between protease inhibitors or non-nucleoside reverse transcriptase inhibitors and direct-acting antivirals, consequently leading to drug toxicity or treatment failure. Concurrent treatment should be avoided if there are major drug interactions. However, close monitoring or dosage adjustment is sufficient in the case of minor drug interactions. This review article will be useful for healthcare personnel for drug interaction management in order to prevent drug toxicity or treatment failure to ensure that HIV/HCV coinfected patients get the most effective treatment.

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References

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