High frequency of potential interactions between direct‐acting antivirals and concomitant therapy in <scp>HIV</scp>/hepatitis C virus‐coinfected patients in clinical practice

<jats:sec><jats:title>Objectives</jats:title><jats:p>The aim of the study was to analyse the frequency and degree of potential drug−drug interactions (<jats:styled-content style="fixed-case">DDI</jats:styled-content>s) between direct‐acting antivirals (<jats:styled-content style="fixed-case">DAA</jats:styled-content>s) and concomitant medication used by <jats:styled-content style="fixed-case">HIV</jats:styled-content>/hepatitis C virus (<jats:styled-content style="fixed-case">HCV</jats:styled-content>)‐coinfected patients, including antiretroviral therapy (<jats:styled-content style="fixed-case">ART</jats:styled-content>) and other drugs.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>All patients with <jats:styled-content style="fixed-case">HIV</jats:styled-content> infection and viraemic <jats:styled-content style="fixed-case">HCV</jats:styled-content> genotype 1, 3 or 4 coinfection attending a tertiary care centre in Spain (November 2014 to November 2015) were included in the study. <jats:styled-content style="fixed-case">DDI</jats:styled-content>s were classified as major, i.e. drugs should not be co‐administered, or minor, i.e. close monitoring, dosage alteration or change in timing may be required if drugs are co‐administered, following the <jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="http://www.hep-druginteractions.org">http://www.hep-druginteractions.org</jats:ext-link> database recommendations.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>A total of 244 patients were included in the study, of whom 224 (92%) were previous injecting drug users. Major <jats:styled-content style="fixed-case">DDI</jats:styled-content>s were found for: paritaprevir‐r/ombitasvir plus dasabuvir (3D), in 60 (44%) of 138 individuals with genotype 1; paritaprevir‐r/ombitasvir (2D), in 22 (37%) of 60 individuals with genotype 4; sofosbuvir/ledipasvir (<jats:styled-content style="fixed-case">SOF</jats:styled-content>/<jats:styled-content style="fixed-case">LDV</jats:styled-content>), in four (2%) of 198 patients with genotype 1 or 4; simeprevir (<jats:styled-content style="fixed-case">SMV</jats:styled-content>) plus <jats:styled-content style="fixed-case">SOF</jats:styled-content>, in 160 (81%) of 198 patients with genotype 1 or 4; daclatasvir (<jats:styled-content style="fixed-case">DCV</jats:styled-content>) plus <jats:styled-content style="fixed-case">SOF</jats:styled-content>, in seven (3%) of 244 patients with genotype 1, 3 or 4 (<jats:italic>P</jats:italic> < 0.001). Minor <jats:styled-content style="fixed-case">DDI</jats:styled-content>s were found for: 3D, in 123 (89%) individuals with genotype 1; 2D, in 52 (87%) individuals with genotype 4; <jats:styled-content style="fixed-case">SOF</jats:styled-content>/<jats:styled-content style="fixed-case">LDV</jats:styled-content>, in 154 (78%) patients with genotype 1 or 4; <jats:styled-content style="fixed-case">SMV</jats:styled-content> plus <jats:styled-content style="fixed-case">SOF</jats:styled-content>, in 129 (65%) patients with genotype 1 or 4; <jats:styled-content style="fixed-case">DCV</jats:styled-content> plus <jats:styled-content style="fixed-case">SOF</jats:styled-content>, in 149 (61%) patients with genotype 1, 3 or 4 (<jats:italic>P</jats:italic> < 0.001).</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Drug−drug interactions between <jats:styled-content style="fixed-case">DAA</jats:styled-content>s and <jats:styled-content style="fixed-case">ART</jats:styled-content> or other commonly prescribed medications are frequently found among <jats:styled-content style="fixed-case">HIV</jats:styled-content>/<jats:styled-content style="fixed-case">HCV</jats:styled-content>‐coinfected patients. Potential major and minor <jats:styled-content style="fixed-case">DDI</jats:styled-content>s are more frequent with 3D, 2D and <jats:styled-content style="fixed-case">SMV</jats:styled-content> plus <jats:styled-content style="fixed-case">SOF</jats:styled-content> regimens.</jats:p></jats:sec>