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DRUGS ABUSE AND CHEMSEX: A NEW CHALLENGE FOR ANTIRETROVIRAL DRUG-DRUG INTERACTION
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20th International Workshop on Clinical Pharmacology of HIV, Hepatitis & Other Antiviral Drugs. May 14-16, 2019. Noordwijk, the Netherlands
Reported by Jules Levin
Tess Martin
Pharmacokinetics and Toxicology
Hôpital La Timone - Marseille - France
Caroline Lions, Helene Laroche, Olivia Faucher-Zaegel, Sylvie Bregigeon, Nadege Neant, Alena Ivanova, Sylvie Quaranta, Veronique Obry-Roguet, Marie-Ange Pieve, Bruno Lacarelle, Isabelle Poizot-Martin, Caroline Solas
"The 3 most commonly drugs used in the cohort were: Cannabis (42%), Poppers (17%) and Cocaine (16%)
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But In chemsex, it was Poppers (37%), Cathinones (13%) and Ecstasy (12%) followed by "G""
20th Intnl Wrkshp Clin Pharm: One third of French HIV group uses illicit drugs, often risking antiretroviral interactions - Mark Mascolini - (05/16/19)
Detected interactions between illicit drugs and antiretrovirals included (1) PK booster-induced inhibition of CYP2D6 and/or CYP3A4 involving MDMA, methamphetamine, cathinones, GHB/GBL, or ketamine (10 cases), (2) CYP2C9 inhibition resulting from using cannabis with efavirenz or etravirine (5 cases), or (3) concomitant use of cocaine and rilpivirine, both of which induce QT prolongation (9 cases). The investigators spotted 13 other potential lower-risk drug-drug interactions in people taking boosted regimens with poppers (7 cases) or cocaine (6 cases). The researchers recommended systematic screening for illicit drug use in people with HIV "to avoid high risk of potential life-threatening toxicities by adjusting the antiretroviral regimen." People taking illicit drugs with antiretrovirals should be warned of potential drug-drug interactions and made aware of toxicity signals.
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