title: [Predictive factors of clinically significant drug-drug interactions among regimens based on protease inhibitors, non-nucleoside reverse transcriptase inhibitors and raltegravir].
abstract: OBJECTIVE
  To determine the prevalence and types of clinically significant drug-drug interactions (CSDI) in the drug regimens of HIV-infected patients receiving antiretroviral treatment.
  
  
  METHODS
  
  
  
  METHODS
  retrospective review of database. Centre: Hospital Universitario Severo Ochoa, Infectious Unit.
  
  
  METHODS
  one hundred and forty-two participants followed by one of the authors were selected from January 1985 to December 2014.
  
  
  METHODS
  from their outpatient medical records we reviewed information from the last available visit of the participants, in relation to HIV infection, comorbidities, demographics and the drugs that they were receiving; both antiretroviral drugs and drugs not related to HIV infection. We defined CSDI from the information sheet and/or database on antiretroviral drug interactions of the University of Liverpool (http://www.hiv-druginteractions.org) and we developed a diagnostic tool to predict the possibility of CSDI. By multivariate logistic regression analysis and by estimating the diagnostic performance curve obtained, we identified a quick tool to predict the existence of drug interactions.
  
  
  RESULTS
  Of 142 patients, 39 (29.11%) had some type of CSDI and in 11.2% 2 or more interactions were detected. In only one patient the combination of drugs was contraindicated (this patient was receiving darunavir/r and quetiapine). In multivariate analyses, predictors of CSDI were regimen type (PI or NNRTI) and the use of 3 or more non-antiretroviral drugs (AUC 0.886, 95% CI 0.828 to 0.944; P=.0001). The risk was 18.55 times in those receiving NNRTI and 27,95 times in those receiving IP compared to those taking raltegravir.
  
  
  CONCLUSIONS
  Drug interactions, including those defined as clinically significant, are common in HIV-infected patients treated with antiretroviral drugs, and the risk is greater in IP-based regimens. Raltegravir-based prescribing, especially in patients who receive at least 3 non-HIV drugs could avoid interactions.
authors.affiliation: Departamento de Medicina Interna, Hospital Universitario Severo Ochoa , Leganés, Madrid, España. Electronic address: mcerveroj@gmail.com.
authors.forename: Miguel
authors.initials: M
authors.lastname: Cervero
authors.affiliation: Departamento de Medicina Interna, Hospital Universitario Severo Ochoa , Leganés, Madrid, España.
authors.forename: Rafael
authors.initials: R
authors.lastname: Torres
authors.affiliation: Departamento de Medicina Interna, Hospital Universitario Severo Ochoa , Leganés, Madrid, España.
authors.forename: Juan José
authors.initials: JJ
authors.lastname: Jusdado
authors.affiliation: Departamento de Medicina Interna, Hospital Universitario Severo Ochoa , Leganés, Madrid, España.
authors.forename: Susana
authors.initials: S
authors.lastname: Pastor
authors.affiliation: Departamento de Medicina Interna, Hospital Universitario Severo Ochoa , Leganés, Madrid, España.
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: Agud
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019380:Anti-HIV Agents / Q000009:adverse effects* / Q000627:therapeutic use; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy*; D017320:HIV Protease Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D000068898:Raltegravir Potassium / Q000009:adverse effects* / Q000627:therapeutic use; D012189:Retrospective Studies; D018894:Reverse Transcriptase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D012307:Risk Factors; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents; D017320:HIV Protease Inhibitors; D018894:Reverse Transcriptase Inhibitors; D000068898:Raltegravir Potassium
keywords: Antiretroviral treatment; Drug-drug interactions; HIV; Interacciones farmacológicas; Tratamiento antirretroviral; Virus de inmunodeficiencia humana