Prevention of drug interactions can optimize treatment of people with HIV

In a dissertation at the Faculty of Medicine, Pharmacist evaluated patients from the Orestes Diniz Training and Reference Center

The interaction of antiretrovirals with other drugs can provoke unpredictable responses of the organism, compromising both the antiretroviral treatment and the effectiveness of the other substances used, indicates a pioneering study in Brazil, carried out in the Postgraduate Program in Health Sciences – Infectology and Tropical Medicine, of the Faculty of Medicine.

In the dissertation Master profile of drug interactions with antiretroviral therapy in patients living with HIV and AIDS at a referral service in Belo Horizonte, defended by the pharmaceutical company Betânia Maria Pontelo, the researcher evaluated the changes in the effects of a given drug in seropositive persons depending on another medicine, food or drink.

In his research, Betânia Pontelo interviewed 304 patients, 76% of them under 50 years of age, accompanied by the Orestes Diniz Center for Training and Reference in Infectious and Parasitic Diseases (CTR / DIP), attached to Hospital das Clínicas. The interviews, carried out from June 2015 to June 2016, showed that 50% of the patients established at least one drug interaction.

“The biggest problem is still self-medication. Sometimes the use of a particular remedy to combat a headache can generate serious problems when interacting with antiretroviral therapy against the HIV virus. In extreme cases, the interaction may lead to death, “says the author of the study, who believes in the importance of a multi-professional work for the effectiveness of treatment of HIV-positive patients.

The motivation of the study was based on the perception of the existence of drug interaction and polypharmacy, characterized by the use of five or more drugs by patients. The early onset of medical comorbidities, ie the presence or association of two or more diseases in the same patient, along with age, is a phenomenon called accelerated aging in HIV infection. Basically, it refers to the early onset of some diseases as a consequence of viral infection, cumulative toxicity of long-term antiretroviral therapy and/or increased frequency of use of tobacco and other substances.

According to Betânia Pontelo, the drug interactions mapped in the study did not impact the effectiveness of antiretroviral treatment. However, the pharmacist points out that the incidence of cardiovascular diseases, non-HIV-related cancer, and renal and hepatic impairment is higher among people over 50 years living with HIV than among individuals of the same age group who do not have HIV. virus. In addition, combining drug effects, early chronic illnesses, cumulative toxicity, and use of drugs such as tobacco, for example, may result in the loss of efficacy of non-antiretroviral drugs.

“Patients with HIV and AIDS are more likely to develop chronic diseases sooner because of the weakening of their immune system. Thus, the tendency is that it is necessary to use more drugs, further increasing the risk of these interactions, “he explains.

Multiprofessional work
For Bethany, the increased frequency of interactions in patients over 50 years and the expected increase in the number of medications suggest that the aging of people with HIV increases the risks. “On the other hand, the improvement of antiretroviral regimens, with safer drugs and less interactions, could counterbalance the effect of aging,” says the author.

The results of the study indicate the need for health teams to be aware of all medications being used by patients and the risks of polypharmacy, and are able to guide patients about interactions.

The next goal of the researcher is to expand the search results to other health facilities. “With multi-professional work, it will be possible to avoid clinically significant interactions of antiretrovirals with other drugs, optimize patient care and assign a better quality of life to people living with HIV,” he concludes.

Dissertation: Profile of drug interactions with antiretroviral therapy in patients living with HIV and AIDS in a referral service in Belo Horizonte
Author: Betânia Maria Pontelo
Program: Post-graduation in Health Sciences – Infectology and Tropical Medicine
Advisor: Unaí Tupinambás
Coordinator: Dirceu Bartolomeu Greco
Defense : August 24, 2017

Carol Prado / Medical School

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