Abstract and Introduction
Abstract
This review looks at the evidence for potential and theoretical risks of combining antiretroviral treatment with drugs prescribed for cardiovascular disease and diabetes. These conditions are common in the HIV-infected population as a result of ageing and the increased risk associated with both HIV infection and antiretroviral intake.
Introduction
HIV-infected individuals are living longer as a result of the impact of antiretroviral treatment and thus are at risk of age-related chronic diseases. The predicted life expectancy in people living with HIV is high; recently, the projected median age at death was estimated to be 75 years, only 7 years less than that for the general population. People living with HIV are often affected by common chronic diseases, which pose new challenges, especially in drug management. HIV infection and antiretroviral treatment themselves are associated with metabolic complications such as dysregulation of glucose and fat metabolism, lipodystrophy syndrome and cardiovascular disease. Antiretrovirals are known to cause significant, potentially fatal, drug interactions. Therefore, starting or modifying treatment for chronic conditions in HIV-infected individuals on combination antiretroviral therapy can result in potentially significant drug interactions, as shown by numerous case series published to date. However, there is often a lack of published evidence on potential drug interactions between antiretrovirals and medications for chronic conditions, and knowledge about interaction potential and mechanisms is required to prevent or manage drug toxicity or treatment failure involving either drug group.
The management of comorbid conditions in HIV-infected people on antiretrovirals is increasingly occurring outside specialist centres, and general physicians should be aware of potential drug–drug interactions. We ask you to consider potential drug interactions in all HIV-infected patients on antiretrovirals who are prescribed drugs for other comorbidities.
Information on potential drug–drug interactions is available from electronic resources such as the University of Liverpool's website (www.hiv-druginteractions.org). Furthermore, physicians can obtain information on potential interactions from a drug's summary of product characteristics (SPC) if no other source is informative. Pharmacists in HIV specialized centres can also provide information on drug–drug interactions over the phone.
This review looks at the evidence for potential and theoretical risks of combining antiretroviral treatment with drugs prescribed for cardiovascular disease and diabetes. These conditions are common in the HIV-infected population as a result of ageing and the increased risk associated with both HIV infection and antiretroviral intake.