Polypharmacy and potential drug–drug interactions for people with HIV in the UK from the Climate‐HIV database

• DOI: 10.1111/hiv.12879
• Publication Date: 2020-07-16T06:33:43Z
• Authors: C Okoli; A Schwenk; M Radford; M Myland; S Taylor; A Darley; J Barnes; A Fox; F Grimson; I Reeves; S Munshi; A Croucher; N Boxall; P Benn; A Paice; J van Wyk; S Khoo
• Keywords: Adult; Male; Anti-HIV Agents; Clinical Decision-Making; Age Factors; Contraindications, Drug; HIV Infections; Comorbidity; Middle Aged; United Kingdom; 3. Good health; Young Adult; 03 medical and health sciences; Cross-Sectional Studies; 0302 clinical medicine; Practice Guidelines as Topic; Polypharmacy; Humans; Drug Interactions; Female; Original Research; Aged

Objectives People with HIV (PWHIV) are likely to need therapies for comorbidities as they age. We assessed risk of drug–drug interactions (DDIs) in PWHIV. Methods The Climate‐HIV electronic recording system was used cross‐sectionally analyse records from PWHIV aged ≥ 18 years attending four UK units a current antiretroviral (ARV) prescription February 2018. Antiretroviral and non‐ARV medications were categorized by clinical significance DDIs (University Liverpool DDI tool). Potential predicted using treatment guidelines commonly recorded comorbidities. Results Among 4630 (44% female), 41% 50 old. average number comedications increased < 1 patients ≤ 24 > 5 75 years; 65% taking one or more comedications. median (interquartile range) non‐ARVs (0–2) 2 (1–5) those years, respectively. Common comorbidities/concurrent health conditions occurred frequently vs . (53% 34%). Boosted protease inhibitors associated the highest proportion contraindicated comedications; dolutegravir raltegravir had fewest. For non‐ARVs, sildenafil quetiapine most result DDIs. Guideline‐recommended treatments hepatitis C, B, tuberculosis proportions contraindications when combined ARV regimens, while malignancy, mental combinations potentially causing requiring dose monitoring adjustment. Conclusions Non‐ARV use is high increases Treatment decisions ageing should consider guideline recommendations