Concomitant use of gastric acid‐reducing agents is frequent among HIV‐1‐infected patients receiving protease inhibitor‐based highly active antiretroviral therapy<sup>*</sup>

HIV Medicine - Tập 8 Số 4 - Trang 220-225 - 2007
Jan van Lunzen1, H.-D. Liess2,3, Keikawus Arastéh4, R Walli5, B Daut5, D. Schürmann6
1University Medical Center Hamburg-Eppendorf, Infectious Diseases Unit, Hamburg, Germany
2Ludwig-Maximilians University, Medizinische Poliklinik, ID Outpatient Clinic, Munich, Germany,
3Vertex Pharmaceuticals (Europe) Ltd, Abingdon, UK
4Vivantes Auguste Viktoria Klinikum, Department of Gastroenterology/Infectious Diseases, Berlin, Germany,
5GlaxoSmithKline, Munich, Germany, and
6Department of Internal Medicine/Infectious Diseases and Pulmonary Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany.

Tóm tắt

ObjectiveThe aim of the study was to assess the frequency of the concurrent use of gastric acid‐reducing agents among HIV‐1‐infected patients treated with highly active antiretroviral therapy (HAART) combinations.MethodsAn anonymous, semistructured, self‐administered questionnaire was consecutively distributed among HIV‐1‐infected patients at routine visits to specialized HIV clinics. The questionnaire contained 17 items asking specifically for information on current antiretroviral treatments and the use of gastric acid‐reducing agents as well as demographic data.ResultsA total of 424 patients in 12 centres participated in the study: 85% were male, 88% were of German nationality, 82% were >35 years of age and 201 (47.4%) were receiving a protease inhibitor (PI)‐containing HAART regimen. Of these, 74 (37%) had received an acid‐reducing drug within the previous 6 months and 43 (58%) were currently still on it. Two‐thirds of patients (64.9%) were treated with proton‐pump inhibitors (pantoprazole, omeprazole or esomeprazole) and 56% of patients on PI‐containing regimens had been taking these drugs for longer than 2 months and up to a maximum of 3 years. The majority of patients (77%) had received the prescription for the acid‐reducing drugs from their HIV specialist and the remaining patients had received over the counter (OTC) medication or prescriptions from other medical personnel.ConclusionsA substantial subset of patients treated with HAART combinations, including those on PI‐containing regimens, were using concomitant acid‐reducing drugs, most often proton‐pump inhibitors. As negative drug–drug interactions between some of the (boosted) PIs and gastric acid‐reducing agents have recently been reported, HIV physicians should take this into account when prescribing PI‐containing HAART combinations in order to avoid an additional risk of treatment failure.

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Tài liệu tham khảo

10.1056/NEJM199803263381301

10.1097/01.qai.0000197071.77482.6e

Sherer RD, 2005, The importance of potency and durability in HIV patient antiretroviral therapy preferences, a telephone survey, 19, 794

10.1592/phco.19.9.708.31544

10.1001/jama.283.2.205

10.1097/00002030-200101050-00011

Sax PE, 2005, Beyond efficacy, the impact of combination antiretroviral therapy on quality of life, 19, 563

Van HeeswijkRPG SaboJP CooperCet al. The pharmacokinetic interactions between tipranavir/ritonavir 500/200 mg bid and atorvastatin antacid and CYP3A4 in healthy adult volunteeers.5th International Workshop on Clinical Pharmacology of HIV Therapy. Rome Italy April 2004 [Abstract 35].

AgarwalaS GrayK WangY GraselaD.Pharmacokinetic effect of omeprazole on atazanavir co‐administered with ritonavir in healthy subjects.12th Conference on Retroviruses and Opportunistic Infections Boston MA February 2005 [Abstract 658].

EMEA Public Statement. Important New Pharmacokinetic Data Demonstrating that REYATAZ (atazanavir sulfate) Combined with NORVIR (ritonavir) and Omeprazole should not be Co‐administered. EMEA/202649/2004 0.1.http://www.emea.eu.int./pdfs/human/press/pus/20264904en.pdf 2004.

LuberA GargV GharakhanianS Vertex HIV Program Team. Survey of medication used by HIV‐infected patients that affect gastrointestinal (GI) acidity and potential for negative drug interactions with HAART.7th International Congress on Drug Therapy in HIV Infection. Glasgow UK November 2004 [Abstract 206].

GuessantS Le CamusC LangJM.Survey on the gastric acid‐modifying medications use in HIV‐infectd (HIV+) patients on antiretroviral (ARV) treatment in France.10th EACS Conference. Dublin Ireland November 2005 [Abstract PE4.6/1].

10.1097/01.qai.0000167477.20428.ce

Luber AD., 2005, Use of acid‐reducing agents in protease inhibitor‐based HAART and the potential for negative treatment outcomes, AIDS Read, 15, 698

10.1097/01.aids.0000189565.87600.4d

10.1097/01.qai.0000197075.56397.a5

Khanlou H, 2006, Response to, Lack of interaction between atazanavir and proton pump inhibitors in HIV-infected patients treated with ritonavir-boosted atazanavir, 41, 394

Furtek KJ, 2006, Proton pump inhibitor therapy in atazanavir‐treated patients, contraindicated?, 41, 394

10.1592/phco.26.3.341

10.1592/phco.26.4.511

10.1097/01.aids.0000226954.95094.39

Robert Koch Institut.Epidemiologisches Bulletin:Sonderausgabe A. Robert Koch Institute Berlin 2006: 1–16 (in German).

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HIV Medicine

Tập 8 Số 4

220-225

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