title: Challenge of coadministering antiretroviral therapy and oral anticoagulants in HIV-positive patients.
abstract: With an improved life expectancy, HIV-positive patients now face interactions between antiretroviral therapy and medications for chronic medical problems. One example is thromboembolism and its treatment with oral anticoagulants. To date, there have been 9 case reports documenting drug interactions between oral anticoagulants and antiretroviral agents. We conducted a retrospective case series to better understand the challenges of anticoagulation management in HIV-positive patients receiving antiretroviral therapy. Of the 9 cases evaluated, the median percentage of international normalized ratio (INR) measurements of blood clotting time within the therapeutic range was 28.6%. Of those INRs outside the therapeutic range, 50.5% were subtherapeutic and 21.2% were supratherapeutic. A heightened awareness of the potential difficulty in achieving adequate anticoagulation in patients on antiretroviral regimens is warranted.
authors.affiliation: Jonathan Lax Treatment Center, Philadelphia FIGHT, Philadelphia, Pennsylvania, USA.
authors.forename: Karen M
authors.initials: KM
authors.lastname: Goldstein
authors.forename: Stephen
authors.initials: S
authors.lastname: Gluckman
authors.forename: Karam
authors.initials: K
authors.lastname: Mounzer
mesh_terms: D000284:Administration, Oral; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D000925:Anticoagulants / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D019380:Anti-HIV Agents; D000925:Anticoagulants