scholarly journals Drug‐Drug Interactions in People Living with HIV at Risk of Hepatic and Renal Impairment: Current Status and Future Perspectives

2022 ◽  
Author(s):  
Nicolas Cottura ◽  
Hannah Kinvig ◽  
Sandra Grañana‐Castillo ◽  
Adam Wood ◽  
Marco Siccardi
Keyword(s):  
At Risk ◽  
Renal Impairment ◽  
Drug Interactions ◽  
Current Status ◽  
People Living With Hiv ◽  
Future Perspectives ◽  
Living With Hiv

scholarly journals High prevalence of sexually transmitted coinfections among at-risk people living with HIV

2020 ◽  
Author(s):  
Kuan-Yin Lin ◽  
Hsin-Yun Sun ◽  
Tai-Fen Lee ◽  
Yu-Chung Chuang ◽  
Un-In Wu ◽  
...  
Keyword(s):  
At Risk ◽  
People Living With Hiv ◽  
Sexually Transmitted ◽  
High Prevalence ◽  
Living With Hiv

scholarly journals Evolving Toward Shared HIV Care Using the Champlain BASE eConsult Service

2019 ◽  
Vol 4 (2) ◽  
pp. 238146831986821
Author(s):  
Claire E. Kendall ◽  
Janessa E. Porter ◽  
Esther S. Shoemaker ◽  
Rachel Seoyeon Kang ◽  
Michael Fitzgerald ◽  
...  
Keyword(s):  
At Risk ◽  
Primary Care Providers ◽  
Question Type ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Local Health ◽  
Care Providers ◽  
Patients At Risk ◽  
Survey Responses ◽  
Living With Hiv

Background. Electronic consultation (eConsultation) is a potential strategy to improve access to specialist expertise and facilitate collaborative care models. The Champlain BASE eConsult service allows for asynchronous communication between primary care providers (PCP) and specialists on a secure, web-based system. HIV experts accessible include HIV physician specialists, HIV pharmacists, and social workers with expertise in HIV. Objective. This study aims to describe the use, value, and utility of this eConsultation service in the care of people living with HIV and to characterize the common question types and clinical topics asked by PCPs. Methods. We analyzed the data from eConsults sent to the HIV specialty group in Ontario’s Champlain Local Health Integration Network between February 2015 and December 2017. Usage data and close-out survey responses were analyzed using descriptive statistics, eConsults were classified using a predefined list of validated taxonomy, and a thematic analysis was performed on the consultation logs to identify common clinical themes. Results. Among the 46 eConsults, the most common question type related to drug treatment (58.7%, n = 27) and management (19.6%, n = 9). The main clinical themes involved the care of significant complexities in people living with HIV, such as comorbidities and drug interactions, and suggestions of coordinated patient care. As well, eConsult was used for advice regarding pre-exposure prophylaxis for HIV-negative patients at risk of HIV infection. PCPs highly valued the eConsult service (average rating 4.8/5). Conclusion. Overall, this study demonstrates that eConsult provides an efficient and valuable service to PCPs caring for patients living with or at risk for HIV by improving access to HIV specialists and facilitating the delivery of team-based comprehensive care.

scholarly journals Improving communication about HIV prevention among people living with HIV and their at-risk social network members in Dar es Salaam, Tanzania

2019 ◽  
Vol 6 (1) ◽  
pp. 1600230 ◽  
Author(s):  
Hellen Siril ◽  
Anna Kaale ◽  
Anna Minja ◽  
Japheth Kilewo ◽  
Ferdinand Mugusi ◽  
...  
Keyword(s):  
At Risk ◽  
Social Network ◽  
Hiv Prevention ◽  
Dar Es Salaam ◽  
People Living With Hiv ◽  
Living With Hiv

Polypharmacy and Drug–Drug Interactions in People Living With Human Immunodeficiency Virus in the Region of Madrid, Spain: A Population-Based Study

2019 ◽  
Vol 71 (2) ◽  
pp. 353-362 ◽  
Author(s):  
Beatriz López-Centeno ◽  
Carlos Badenes-Olmedo ◽  
Ángel Mataix-Sanjuan ◽  
Katie McAllister ◽  
José M Bellón ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Drug Interactions ◽  
Age Groups ◽  
Population Based ◽  
People Living With Hiv ◽  
Traffic Light ◽  
Population Based Study ◽  
Immunodeficiency Virus ◽  
Red Flag ◽  
Living With Hiv

Abstract Background Drug–drug interactions (DDIs) that involve antiretrovirals (ARVs) tend to cause harm if unrecognized, especially in the context of comorbidity and polypharmacy. Methods A linkage was established between the drug dispensing registry of Madrid and the Liverpool human immunodeficiency virus (HIV) DDI database (January 2017–June 2017). Polypharmacy was defined as the use of ≥5 non-HIV medications, and DDIs were classified by a traffic-light ranking for severity. Results A total of 22 945 people living with HIV (PLWH) and 6 613 506 individuals without HIV had received medications. ARV regimens were predominantly based on integrase inhibitors (51.96%). Polypharmacy was higher in PLWH (32.94%) than individuals without HIV (22.16%; P < .001); this difference was consistently observed across all age strata except for individuals ≥75 years. Polypharmacy was more common in women than men in both PLWH and individuals without HIV. The prevalence of contraindicated combinations involving ARVs was 3.18%. Comedications containing corticosteroids, quetiapine, or antithrombotic agents were associated with the highest risk for red-flag DDI, and the use of raltegravir- or dolutegravir-based antiretroviral therapy was associated with an adjusted odds ratio of 0.72 (95% confidence interval, .60–.88; P = .001) for red-flag DDI. Conclusions Polypharmacy was more frequent among PLWH across all age groups except those aged ≥75 years and was more common in women. The detection of contraindicated medications in PLWH suggests a likely disconnect between hospital and community prescriptions. Switching to alternative unboosted integrase regimens should be considered for patients with risk of harm from DDIs.

Uptake and trends in ordering of funded hepatitis B immunisation for priority populations in Victoria, Australia, 2013–2014

Sexual Health ◽  
2017 ◽  
Vol 14 (2) ◽  
pp. 188
Author(s):  
Jennifer H. MacLachlan ◽  
Benjamin C. Cowie
Keyword(s):  
At Risk ◽  
Hepatitis B ◽  
Risk Groups ◽  
Hepatitis B Vaccine ◽  
People Living With Hiv ◽  
Department Of Health ◽  
Priority Populations ◽  
Living With Hiv ◽  
The Impact ◽  
Over Time

Background The Department of Health and Human Services in Victoria provides funded hepatitis B vaccine to many priority groups at risk of acquiring infection. We aimed to determine the uptake of vaccine ordering for at-risk groups over time, to assess any trends and identify any gaps in prevention of hepatitis B for those at risk. Methods: Routinely collected administrative data regarding the indication for vaccine ordered by practitioners were analysed for the period June 2013 to December 2014. Number of doses and courses distributed was determined and compared with the estimated size of the priority populations. Results: During the 18-month period assessed, 20 498 doses of funded hepatitis B vaccine were ordered, equating to ~5700 complete courses, with the overall number of orders per quarter increasing between 2013 and 2014. The most common indication was being a household or sexual contact of people living with hepatitis B (2803 courses, 49.2% of the total), equating to approximately one course per new chronic hepatitis B notification. The remaining doses were largely distributed to people living with HIV (648 courses, 11.4%), people living with hepatitis C (621 courses, 10.9%), and people who inject drugs (594 courses, 10.4%). Conclusions: This analysis demonstrates that access to hepatitis B immunisation among priority populations appears to have increased in Victoria during 2013–14, however it could still be improved. Continued assessment of these data over time will be important to measure the impact of interventions on increasing the reach of the funded vaccine program.

scholarly journals Stereotypes About People Living with HIV: Implications for Perceptions of HIV Risk and Testing Frequency Among At-Risk Populations

2012 ◽  
Vol 24 (6) ◽  
pp. 574-581 ◽  
Author(s):  
Valerie A. Earnshaw ◽  
Laramie R. Smith ◽  
Stephenie R. Chaudoir ◽  
I-Ching Lee ◽  
Michael M. Copenhaver
Keyword(s):  
At Risk ◽  
Hiv Risk ◽  
People Living With Hiv ◽  
Testing Frequency ◽  
At Risk Populations ◽  
Living With Hiv

scholarly journals Nevirapine pharmacokinetics in HIV-infected persons receiving rifapentine and isoniazid for TB prevention

2020 ◽  
Author(s):  
A T Podany ◽  
J Leon-Cruz ◽  
J Hakim ◽  
K Supparatpinyo ◽  
A Omoz-Oarhe ◽  
...  
Keyword(s):  
Drug Interaction ◽  
Drug Interactions ◽  
Geometric Mean ◽  
People Living With Hiv ◽  
Oral Clearance ◽  
Geometric Mean Ratio ◽  
Antiretroviral Drug ◽  
Trough Concentrations ◽  
Study Participants ◽  
Living With Hiv

Abstract Background The use of rifamycin antibiotics for TB prevention carries a risk of detrimental drug–drug interactions with concomitantly used ART. Objectives To evaluate the interaction of the antiretroviral drug nevirapine in combination with 4 weeks of daily rifapentine and isoniazid for TB prevention in people living with HIV. Methods Participants were individuals enrolled in the BRIEF-TB study receiving nevirapine and randomized to the rifapentine/isoniazid arm of the study. Participants provided sparse pharmacokinetic (PK) sampling at baseline and weeks 2 and 4 for trough nevirapine determination. Nevirapine apparent oral clearance (CL/F) was estimated and the geometric mean ratio (GMR) of CL/F prior to and during rifapentine/isoniazid was calculated. Results Seventy-eight participants had evaluable PK data: 61 (78%) female, 51 (65%) black non-Hispanic and median (range) age of 40 (13–66) years. Median (IQR) nevirapine trough concentrations were: week 0, 7322 (5266–9302) ng/mL; week 2, 5537 (3552–8462) ng/mL; and week 4, 5388 (3516–8243) ng/mL. Sixty out of 78 participants (77%) had nevirapine concentrations ≥3000 ng/mL at both week 2 and 4. Median (IQR) nevirapine CL/F values were: week 0 pre-rifapentine/isoniazid, 2.03 (1.58–2.58) L/h; and during rifapentine/isoniazid, 2.62 (1.81–3.42) L/h. The GMR (90% CI) for nevirapine CL/F was 1.30 (1.26–1.33). Conclusions The CL/F of nevirapine significantly increased with concomitant rifapentine/isoniazid. The decrease in nevirapine trough concentrations during rifapentine/isoniazid therapy suggests induction of nevirapine metabolism, consistent with known rifapentine effects. The magnitude of this drug–drug interaction suggests daily rifapentine/isoniazid for TB prevention should not be co-administered with nevirapine-containing ART.

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