Ageing with HIV: medication use and risk for potential drug-drug interactions
Catia Marzolini, David Back, Rainer Weber, Hansjakob Furrer, Matthias Cavassini, Alexandra Calmy, Pietro Vernazza, Enos Bernasconi, Saye Khoo, Manuel Battegay, Luigia Elzi, Swiss HIV Cohort Study Members, M Battegay, E Bernasconi, J Böni, H C Bucher, P Bürgisser, A Calmy, S Cattacin, M Cavassini, R Dubs, M Egger, L Elzi, M Fischer, M Flepp, A Fontana, P Francioli, H Furrer, C Fux, M Gorgievski, H Günthard, H H Hirsch, B Hirschel, I Hösli, Ch Kahlert, L Kaiser, U Karrer, C Kind, Th Klimkait, B Ledergerber, G Martinetti, B Martinez, N Müller, D Nadal, M Opravil, F Paccaud, G Pantaleo, A Rauch, S Regenass, M Rickenbach, C Rudin, P Schmid, D Schultze, J Schüpbach, R Speck, P Taffé, P Tarr, A Telenti, A Trkola, P Vernazza, R Weber, S Yerly, Catia Marzolini, David Back, Rainer Weber, Hansjakob Furrer, Matthias Cavassini, Alexandra Calmy, Pietro Vernazza, Enos Bernasconi, Saye Khoo, Manuel Battegay, Luigia Elzi, Swiss HIV Cohort Study Members, M Battegay, E Bernasconi, J Böni, H C Bucher, P Bürgisser, A Calmy, S Cattacin, M Cavassini, R Dubs, M Egger, L Elzi, M Fischer, M Flepp, A Fontana, P Francioli, H Furrer, C Fux, M Gorgievski, H Günthard, H H Hirsch, B Hirschel, I Hösli, Ch Kahlert, L Kaiser, U Karrer, C Kind, Th Klimkait, B Ledergerber, G Martinetti, B Martinez, N Müller, D Nadal, M Opravil, F Paccaud, G Pantaleo, A Rauch, S Regenass, M Rickenbach, C Rudin, P Schmid, D Schultze, J Schüpbach, R Speck, P Taffé, P Tarr, A Telenti, A Trkola, P Vernazza, R Weber, S Yerly
Abstract
Objectives: To compare the use of co-medication, the potential drug-drug interactions (PDDIs) and the effect on antiretroviral therapy (ART) tolerability and efficacy in HIV-infected individuals according to age, ≥ 50 years or <50 years.
Methods: All ART-treated participants were prospectively included once during a follow-up visit of the Swiss HIV Cohort Study. Information on any current medication was obtained by participant self-report and medical prescription history. The complete treatment was subsequently screened for PDDIs using a customized version of the Liverpool drug interaction database.
Results: Drug prescriptions were analysed for 1497 HIV-infected individuals: 477 age ≥ 50 and 1020 age <50. Older patients were more likely to receive one or more co-medications compared with younger patients (82% versus 61%; P < 0.001) and thus had more frequent PDDIs (51% versus 35%; P < 0.001). Furthermore, older patients tended to use a higher number of co-medications and certain therapeutic drug classes more often, such as cardiovascular drugs (53% versus 19%; P < 0.001), gastrointestinal medications (10% versus 6%; P = 0.004) and hormonal agents (6% versus 3%; P = 0.04). PDDIs with ART occurred mainly with cardiovascular drugs (27%), CNS agents (22%) and methadone (6%) in older patients and with CNS agents (27%), methadone (15%) and cardiovascular drugs (11%) in younger patients. The response to ART did not differ between the two groups.
Conclusions: The risk for PDDIs with ART increased in older patients who take more drugs than their younger HIV-infected counterparts. However, medication use in older and younger patients did not differ in terms of effect on antiretroviral tolerability and response.
Source: PubMed