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Prevalence of clinically significant drug-drug interactions with antiretrovirals against HIV over time: a systematic review of the literature
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International Workshop on Clinical Pharmacology of HIV, Hepatitis and Other Antiviral Drugs, September 20-22, 2021
Daryl Hodge1, Eva Maria Hodel1, Elen Hughes2, Phoebe Hazenberg1,3, Saye Khoo1,3
1. University of Liverpool 2.Wirral University Teaching Hospital 3.Liverpool University Hospital Foundation Trust
from Jules: Older Age correlates with contraindicated or strongly not recommended drug-drug interaction, see Figure 4. For a moment, I'd like to address a key facet the aging problem.
There is so much data & research finding that aging PWH experience more comorbidities & at earlier ages sometimes 15 years earlier compared to HIV-negative people. A key question is if PWH who started ART earlier than those in early days of HIV when they took more toxic drugs with lower nadir CD4 and with longer perhaps time with viral presence - the question is if people who started ART earlier & with less toxic or safer ARTs will they experience the same aging issues as those older PWH who started late, with more toxic ARTs, with lower CD4 nadir. I feel confident although a few risk factors may be removed or not as bad many of the factors contributing to "accelerated" or accentuated" aging remain present & so these newer or younger PWH will experience this problem but it will be less of a problem & for a given individual perhaps to as bad. But bear in mind many PWH do not start ARTs immediately as recommended but delay until CD4s are not so high, its estimated 40% in the USA with HIV have detectable viral load which is a risk factor for inflammation & immune activation, for comorbidities. Immunosenesence may still be present, we do not know for sure how present or if there is a big difference. HIV causes mitochondrial damage, that persists. Gut issues are not eliminated. HIV causes immune activation & inflammation despite viral suppression.
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