title: [Severe or life-threatening interactions between antiretrovirals and non-HIV drugs].
abstract: Highly active antiretroviral therapy has helped to improved control of the HIV infection, and has led to a progressively older population with the infection having a life expectancy quite similar to that of the general population. On the other hand, it is also known that HIV infection, even in patients with undetectable viral loads and good immunity, carries an increased cardiovascular risk, as well as an increased incidence of certain cancers. Therefore, the majority of HIV-infected patients receive several drugs (either prescribed by the physician or self-administered) combined with antiretrovirals. This article reviews the interactions between antiretrovirals and other drugs that can cause significant damage to patients, or even be life-threatening and of whom clinicians, especially those not directly treating HIV-infected patients, should be aware. A review is also presented on the implications of interactions between antiretrovirals and other drugs in special situations, such as the co-administration with cytostatics, immunesuppressants used in solid organ transplantation, or patients receiving new treatments for hepatitisC. Generally, combinations with two nucleos(t)ide reverse transcriptase inhibitors and raltegravir (or in the near future, dolutegravir) are those with less potential for clinically significant interactions.
authors.affiliation: Servicio de Enfermedades Infecciosas, Hospital Clínic-IDIBAPS/Universidad de Barcelona, Barcelona, España. Electronic address: cmanzard@clinic.ub.es.
authors.forename: Christian
authors.initials: C
authors.lastname: Manzardo
authors.affiliation: Servicio de Enfermedades Infecciosas y Departamento de Farmacia, Hospital Clínic-IDIBAPS/Universidad de Barcelona, Barcelona, España.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Tuset
authors.affiliation: Servicio de Enfermedades Infecciosas, Hospital Clínic-IDIBAPS/Universidad de Barcelona, Barcelona, España.
authors.forename: Jose M
authors.initials: JM
authors.lastname: Miró
authors.affiliation: Servicio de Enfermedades Infecciosas, Hospital Clínic-IDIBAPS/Universidad de Barcelona, Barcelona, España.
authors.forename: Jose M
authors.initials: JM
authors.lastname: Gatell
mesh_terms: D000890:Anti-Infective Agents / Q000009:adverse effects / Q000493:pharmacokinetics; D044966:Anti-Retroviral Agents / Q000009:adverse effects* / Q000493:pharmacokinetics; D000927:Anticonvulsants / Q000009:adverse effects / Q000493:pharmacokinetics; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000493:pharmacokinetics; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D002121:Calcium Channel Blockers / Q000009:adverse effects / Q000493:pharmacokinetics; D002318:Cardiovascular Diseases / Q000139:chemically induced; D051544:Cytochrome P-450 CYP3A / Q000378:metabolism; D065701:Cytochrome P-450 CYP3A Inducers / Q000009:adverse effects / Q000493:pharmacokinetics; D065692:Cytochrome P-450 CYP3A Inhibitors / Q000009:adverse effects / Q000493:pharmacokinetics; D004347:Drug Interactions; D004700:Endocrine System Diseases / Q000139:chemically induced; D004876:Ergot Alkaloids / Q000009:adverse effects / Q000493:pharmacokinetics; D015658:HIV Infections / Q000188:drug therapy; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects / Q000493:pharmacokinetics; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000493:pharmacokinetics; D009422:Nervous System Diseases / Q000139:chemically induced; D011619:Psychotropic Drugs / Q000009:adverse effects / Q000493:pharmacokinetics; D012206:Rhabdomyolysis / Q000139:chemically induced
chemical_list: D000890:Anti-Infective Agents; D044966:Anti-Retroviral Agents; D000927:Anticonvulsants; D000970:Antineoplastic Agents; D002121:Calcium Channel Blockers; D065701:Cytochrome P-450 CYP3A Inducers; D065692:Cytochrome P-450 CYP3A Inhibitors; D004876:Ergot Alkaloids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007166:Immunosuppressive Agents; D011619:Psychotropic Drugs; D051544:Cytochrome P-450 CYP3A; C510163:CYP3A4 protein, human
keywords: Drug interactions; Highly active antiretroviral therapy; Inhibidores de la integrasa; Inhibidores de la proteasa; Integrase inhibitors; Interacciones farmacológicas; Protease inhibitors; Tratamiento antirretroviral de gran actividad