Lopez-Centeno, Beatriz, Badenes-Olmedo, Carlos, Mataix-Sanjuan, Angel, McAllister, Katie, Bellon, Jose M, Gibbons, Sara, Balsalobre, Pascual, Perez-Latorre, Leire, Benedi, Juana, Marzolini, Catia et al (show 4 more authors)
(2020)
Polypharmacy and Drug-Drug Interactions in People Living With Human Immunodeficiency Virus in the Region of Madrid, Spain: A Population-Based Study.
, United States.
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Abstract
<h4>Background</h4>Drug-drug interactions (DDIs) that involve antiretrovirals (ARVs) tend to cause harm if unrecognized, especially in the context of comorbidity and polypharmacy.<h4>Methods</h4>A linkage was established between the drug dispensing registry of Madrid and the Liverpool human immunodeficiency virus (HIV) DDI database (January 2017-June 2017). Polypharmacy was defined as the use of ≥5 non-HIV medications, and DDIs were classified by a traffic-light ranking for severity.<h4>Results</h4>A total of 22 945 people living with HIV (PLWH) and 6 613 506 individuals without HIV had received medications. ARV regimens were predominantly based on integrase inhibitors (51.96%). Polypharmacy was higher in PLWH (32.94%) than individuals without HIV (22.16%; P < .001); this difference was consistently observed across all age strata except for individuals ≥75 years. Polypharmacy was more common in women than men in both PLWH and individuals without HIV. The prevalence of contraindicated combinations involving ARVs was 3.18%. Comedications containing corticosteroids, quetiapine, or antithrombotic agents were associated with the highest risk for red-flag DDI, and the use of raltegravir- or dolutegravir-based antiretroviral therapy was associated with an adjusted odds ratio of 0.72 (95% confidence interval, .60-.88; P = .001) for red-flag DDI.<h4>Conclusions</h4>Polypharmacy was more frequent among PLWH across all age groups except those aged ≥75 years and was more common in women. The detection of contraindicated medications in PLWH suggests a likely disconnect between hospital and community prescriptions. Switching to alternative unboosted integrase regimens should be considered for patients with risk of harm from DDIs.
| Item Type: | Conference or Workshop Item (Unspecified) |
|---|---|
| Uncontrolled Keywords: | HIV, polypharmacy, drug-drug interactions, antiretroviral drugs, population study |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Systems, Molecular and Integrative Biology |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 17 Nov 2021 09:44 |
| Last Modified: | 18 Jan 2023 21:24 |
| DOI: | 10.1093/cid/ciz811 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3143287 |
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