Third International Congress Drug Therapy in HIV Infection 3-7 November 1996 Glasgow, UK

INTERACTIONS WITH ANTI-HIV DRUGS - AN OVERVIEW

Alasdair Breckenridge
Department of Pharmacology & Therapeutics, University of Liverpool, Liverpool, L69 3BX.

Int Cong Drug Therapy HIV 1996 Nov 3-7;3:Abstract No. 9.1
AIDS 1996, Vol. 10 (Suppl. 2);S6

There are several separate facets concerning the issue of drug interactions with anti HIV drugs. First, current therapy for all stages of HIV disease increasingly involves multiple drug administration where additive or synergistic drug interactions are used for therapeutic benefit, delaying the onset and extent of viral resistance. The nature and extent of the interaction is a prime determinant of the risk-benefit ratio to the individual patient. Second, the patients are frequently administered other agents e.g. antifungals and antibiotics to combat HIV related opportunistic infections; these may influence the disposition of anti HIV drugs. Third, the effect that anti HIV drugs have on the efficacy and safety of other co-administered drugs merits consideration. Fourth, the adverse effects of drug interactions may be amplified as the disease progresses.

Currently the most important therapeutic interactions are those involving different reverse transcriptase (RT) inhibitors, and those between protease inhibitors and RT inhibitors. At the cellular level any agent which modifies the phosphorylation of RT inhibitors may also alter their therapeutic action; the inhibitory effect of protease inhibitors on various isoforns of cytochrome P450 has relevance for the efficacy of co administered anti HIV drugs and other therapy too. Measurement of serum levels of RT inhibitors may not predict or correlate with activity or toxicity, and other stratagems must be worked out to establish the basis and extent of these interactions; use of serum levels of protease inhibitors may be more useful.

CONCLUSIONS:

Presenting author: Alasdair Breckenridge

1996-11-03
9.1

Originally published in AIDS Volume 10, Supplement 2 and hosted with permission of the publisher Lippincott Williams & Wilkins, 250 Waterloo Road, London, SE1 8RD, UK. Tel: +44 (0)20 7981 0700 Fax: +44 (0) 7981 0701

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