title: Comparing the Frequencies of Contraindicated Drug-Drug Interactions Between Differing Antiretroviral Regimens in HIV-Infected Patients.
abstract: BACKGROUND
  HIV-infected patients receiving antiretroviral therapy (ART) are at risk for contraindicated drug-drug interactions (XDDIs).
  
  
  OBJECTIVE
  This study compared the frequency of XDDIs between different types of ART regimens.
  
  
  METHODS
  A retrospective cohort study was performed among adult HIV-infected patients receiving care at either the Upstate New York Veterans' Healthcare Administration or the University of New Mexico Truman Health Services between 2000 and 2013. The cohort consisted of patients receiving traditional ART regimens composed of 2 nucleoside reverse transcriptase inhibitors plus either a nonnucleoside reverse transcriptase inhibitor (NNRTI), a protease inhibitor (PI), or an integrase strand transfer inhibitor (INSTI). The primary outcome was the presence of XDDIs. Lexi-Interact was used to define XDDIs.
  
  
  RESULTS
  Of the 1329 patients who met inclusion criteria, 45.7%, 34.2%, and 20.1% were receiving an NNRTI-, PI-, or INSTI- based ART regimen, respectively. Among the 128 (9.6%) patients with an XDDI, more than half (53.9%) had an interaction involving ART. The presence of XDDIs was highest for PI-based regimens (16.3%) compared with INSTI- (7.9%) and NNRTI-based (5.4%) regimens; P < 0.001. The variables independently associated with XDDIs were ART regimen type (prevalence ratio [PR] = 1.91; 95% CI = 1.51-2.40, P < 0.001), use of ≥6 non-HIV medications (PR = 5.84; 95% CI = 3.92-8.71, P < 0.001), and age ≥40 years (PR = 1.62; 95% CI = 0.92-2.86, P = 0.10).
  
  
  CONCLUSIONS
  The probability of XDDIs varies as a function of ART regimen type, advanced age, and use of multiple non-HIV medications.
authors.affiliation: 1 University of New Mexico College of Pharmacy, Albuquerque, NM, USA.
authors.forename: Bernadette
authors.initials: B
authors.lastname: Jakeman
authors.affiliation: 2 Albany College of Pharmacy and Health Sciences, NY, USA.
authors.forename: Mona
authors.initials: M
authors.lastname: Nasiri
authors.affiliation: 1 University of New Mexico College of Pharmacy, Albuquerque, NM, USA.
authors.forename: Lindsey
authors.initials: L
authors.lastname: Ruth
authors.affiliation: 2 Albany College of Pharmacy and Health Sciences, NY, USA.
authors.forename: Caroline
authors.initials: C
authors.lastname: Morse
authors.affiliation: 3 Stratton Veterans Affairs Medical Center, Albany, NY, USA.
authors.forename: Sheran
authors.initials: S
authors.lastname: Mahatme
authors.affiliation: 2 Albany College of Pharmacy and Health Sciences, NY, USA.|3 Stratton Veterans Affairs Medical Center, Albany, NY, USA.
authors.forename: Nimish
authors.initials: N
authors.lastname: Patel
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D000075202:Contraindications; D004347:Drug Interactions; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009516:New Mexico; D009518:New York; D012044:Regression Analysis; D012189:Retrospective Studies; D018894:Reverse Transcriptase Inhibitors / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents; D018894:Reverse Transcriptase Inhibitors
keywords: HIV; drug-drug interactions; highly active antiretroviral therapy