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Canadian Journal of Cardiology

Getting to the Heart of the Matter: A Review of Drug Interactions Between HIV Antiretrovirals and Cardiology Medications

Published:December 18, 2018DOI:https://doi.org/10.1016/j.cjca.2018.12.020

      Abstract

      The past 20 years have seen remarkable advances in the treatment of HIV such that most people diagnosed with HIV today can live long, healthy lives by taking antiretrovirals which are usually life-long. Advancements in antiretroviral therapy include the availability of well tolerated, single tablet regimens that are associated with a lower risk of drug-drug interactions. Despite this, many people living with HIV infection might be taking antiretroviral agents that are associated with significant drug-drug interactions. Because HIV infection itself is associated with cardiovascular complications and this population is living longer, concomitant use of antiretrovirals and medications to treat cardiovascular-related diseases is often required. For this reason, it is imperative that clinicians are aware of the potential for clinically significant drug-drug interactions between antiretroviral agents and cardiac medications as well as the useful HIV drug interaction resources that might provide guidance. Available data on significant interactions are summarized and suggested guidance regarding management is discussed.

      Résumé

      Les 20 dernières années ont vu des progrès remarquables dans le traitement du VIH de sorte que la plupart des gens qui découvrent être porteurs du VIH aujourd’hui peuvent vivre une vie longue et en bonne santé grâce aux agents antirétroviraux qu’ils prendront habituellement pour toute la vie. Les progrès réalisés en matière de traitement antirétroviral ont permis d’offrir des schémas thérapeutiques à comprimés uniques bien tolérés qui sont associés à un risque réduit d’interactions médicament-médicament. Malgré tout, de nombreuses personnes vivant avec le VIH peuvent prendre des agents antirétroviraux qui sont associés à des interactions médicament-médicament importantes. Étant donné que l’infection par le VIH est elle-même associée à des complications cardiovasculaires et que les personnes atteintes vivent plus longtemps qu’avant, celles-ci doivent souvent prendre en concomitance des agents antirétroviraux et des médicaments pour les maladies cardiovasculaires. C’est pourquoi il est impératif que les cliniciens connaissent la possibilité d’interactions médicament-médicament importantes sur le plan clinique entre les agents antirétroviraux et les médicaments contre les troubles cardiaques, ainsi que les ressources utiles sur les interactions avec les médicaments contre le VIH qui peuvent les aider. Les données dont on dispose sur les interactions d’importance sont résumées, et des propositions d’orientations relatives à la prise en charge sont abordées.
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