HIV Clinical Trial
Official title:
Use of Concomitant Medications in HIV-1 Infected Patients in a Large Community Practice in Sydney, Australia
For the majority of patients, management of HIV-1 infection involves effective and well
tolerated antiretroviral therapy with simplified pill load and dosing, exemplified by the
availability of single tablet regimens (STRs) with single tablet once daily dosing. STR
therapy has been shown to improve adherence and reduce hospitalisations (Cohen et al., 2013;
Sax et al., 2012).
However, the aging of the HIV cohort in Australia and globally has raised issues of
increasing co-morbidities and consequent polypharmacy to manage these (Jansson & Wilson,
2012; Edelman et al., 2013).
Polypharmacy may not only impact on adherence, but also increases the potential for
drug-drug interactions (Holtzman et al., 2013).
Stribild, a highly effective STR, contains cobicistat to boost the levels of the component
integrase inhibitor, elvitegravir. Cobicistat does not have antiretroviral activity, but
acts by inhibiting Cyp3A4 of the cytochrome p450 metabolic pathway. Other drugs metabolized
via this pathway may be affected by this drug-drug interaction (Rogatto et al., 2014).
Additionally there is evidence of increased risk of nephrotoxicity with co-administration of
tenofovir and non-steroidal anti-inflammatory medication (NSAIDS) (Marcotte et al., 2008).
Data on use of concomitant medications in Australian patients with HIV is sparse. This study
aims to determine, in a large caseload community HIV practice, the use of concomitant
medications in HIV, patient pill load and dosing frequency, and potential drug-drug
interactions with stribild.
n/a
Observational Model: Cohort, Time Perspective: Retrospective
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