Prevalence and type of drug-drug interactions involving ART in patients attending a specialist HIV outpatient clinic in Kampala, Uganda

Scale-up of HIV services in sub-Saharan Africa has rapidly increased, necessitating evaluation of medication safety in these settings. Drug-drug interactions (DDIs) involving antiretrovirals (ARVs) in sub-Saharan Africa are poorly characterized. We evaluated the prevalence and type of ARV DDIs in Ug...

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Bibliographic Details
Published in:Journal of antimicrobial chemotherapy 2015-12, Vol.70 (12), p.3317-3322
Main Authors: Seden, K, Merry, C, Hewson, R, Siccardi, M, Lamorde, M, Byakika-Kibwika, P, Laker, E, Parkes-Ratanshi, R, Back, D J, Khoo, S H
Format: Article
Language:English
Subjects:
Adult
Ambulatory Care Facilities
Anti-Infective Agents - therapeutic use
Anti-Retroviral Agents - therapeutic use
Antiretroviral drugs
Drug Interactions
Female
HIV
HIV Infections - drug therapy
Human immunodeficiency virus
Humans
Male
Middle Aged
Original Research
Outpatient care facilities
Prevalence
Retrospective Studies
Uganda
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Summary:Scale-up of HIV services in sub-Saharan Africa has rapidly increased, necessitating evaluation of medication safety in these settings. Drug-drug interactions (DDIs) involving antiretrovirals (ARVs) in sub-Saharan Africa are poorly characterized. We evaluated the prevalence and type of ARV DDIs in Ugandan outpatients and identified the patients most at risk. A total of 2000 consecutive patients receiving ARVs at the Infectious Diseases Institute, Kampala were studied. The most recent prescription for each patient was screened for clinically significant DDIs using www.hiv-druginteractions.org. Univariable and multivariable logistic regression were used to identify risk factors for DDIs. A screening tool was developed using significant risk factors and tested in a further 500 patients. Clinically significant DDIs were observed in 374 (18.7%) patients, with a total of 514 DDIs observed. Only 0.2% of DDIs involved a contraindicated combination. Comedications commonly associated with DDIs were antibiotics (4.8% of 2000 patients), anthelmintics (2.2%) and antifungals (3.5%). Patient age, gender, CD4 count and weight did not affect risk of DDIs. In multivariable analysis, the patient factors that independently increased risk of DDIs were two or more comedications (P 
ISSN:0305-7453
1460-2091
DOI:10.1093/jac/dkv259