Comorbidities, comedications and potential drug-drug interactions among people living with HIV in China.

IF 3.2 3区医学 Q2 INFECTIOUS DISEASES

HIV Medicine Pub Date : 2025-10-16 DOI:10.1111/hiv.70127

Yidan Zhao, Xiaobing Fu, Yuecheng Yang, Luqian Shi, Leshuang Wu, Qunbo Zhou, Yong Zhang, Xin Xin, Lei Han, Haibo Jiang, Yingying Ding

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引用次数: 0

Abstract

Objective: With increasing life expectancy among HIV-positive persons in China, comorbidities, polypharmacy and potential drug-drug interactions (DDIs) present growing challenges. We evaluated these issues in the integrase strand transfer inhibitor (INSTI) era of antiretroviral therapy (ART).

Methods: In this multi-site, cross-sectional study, we enrolled 5238 HIV-positive persons from four geographically diverse regions of China. Using the University of Liverpool HIV Drug Interactions Database, we categorized potential DDIs as follows: no interaction (green), weak interaction (yellow), interaction requiring dose adjustment/monitoring (amber) or contraindicated (red).

Results: The mean age of participants was 41.7 years; 1121 (21.4%) had at least one comorbidity. Notable treatment gaps were observed: 516 (46.0%) comorbid cases received no treatment, with particularly low treatment rates for hypertension (21.8%, 81/372), dyslipidaemia (45.3%, 86/190), diabetes (15.2%, 24/158), cardiovascular disease (23.0%, 20/87) and endocrine/metabolic disorders (58.6%, 85/142). Non-ART medication use was reported by 604 (11.5%), most commonly antihypertensives (6.1%, 320/5238), antidiabetics (3.4%, 176/5238). Among medication users, 253 (41.8%) had potential DDIs: red-flagged (1.0%, 4/604), amber-flagged (32.5%, 198/604) and yellow-flagged (8.3%, 51/604). Multivariable analysis revealed older age, overweight/obesity, urban insurance, lower income, lower CD4 counts and INSTI-based regimens were positively associated with comorbidities and comedication use. Potential DDI risk increased with older age, longer ART duration, smoking, polypharmacy and non-nucleoside reverse transcriptase inhibitors/protease inhibitor-based regimens.

Conclusions: Our findings reveal high comorbidity prevalence with significant treatment gaps and frequent potential DDIs among Chinese HIV-positive persons, particularly involving cardiometabolic medications and non-INSTI ART regimens. These results underscore the urgent need for integrated HIV/chronic care models incorporating routine DDI screening to improve clinical outcomes.

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中国艾滋病毒感染者的合并症、药物治疗和潜在的药物相互作用。

目的：随着中国hiv阳性人群预期寿命的增加，合并症、多种用药和潜在的药物相互作用（ddi）提出了越来越多的挑战。我们在整合酶链转移抑制剂（INSTI）时代的抗逆转录病毒治疗（ART）中评估了这些问题。方法：在这项多地点横断面研究中，我们从中国四个不同地理区域招募了5238名hiv阳性患者。使用利物浦大学HIV药物相互作用数据库，我们将潜在的ddi分类如下：无相互作用（绿色），弱相互作用（黄色），需要剂量调整/监测的相互作用（琥珀色）或禁忌（红色）。结果：参与者平均年龄为41.7岁；1121例（21.4%）至少有一种合并症。有516例（46.0%）合并症患者未接受治疗，其中高血压（21.8%,81/372）、血脂异常（45.3%,86/190）、糖尿病（15.2%,24/158）、心血管疾病（23.0%,20/87）和内分泌/代谢疾病（58.6%,85/142）的治愈率特别低。604例（11.5%）报告使用非抗逆转录病毒药物，最常见的是抗高血压（6.1%,320/5238），抗糖尿病（3.4%,176/5238）。在药物使用者中，253人（41.8%）有潜在的ddi：红色标记（1.0%,4/604），琥珀色标记（32.5%,198/604）和黄色标记（8.3%,51/604）。多变量分析显示，年龄较大、超重/肥胖、城市保险、收入较低、CD4计数较低和基于胰岛素的治疗方案与合并症和药物使用呈正相关。潜在的DDI风险随着年龄的增长、ART持续时间的延长、吸烟、多种药物和基于非核苷类逆转录酶抑制剂/蛋白酶抑制剂的方案而增加。结论：我们的研究结果显示，中国hiv阳性患者的合并症患病率高，治疗缺口明显，潜在的ddi频繁，特别是涉及心脏代谢药物和非insti抗逆转录病毒治疗方案。这些结果强调了迫切需要将常规DDI筛查纳入艾滋病毒/慢性护理综合模式，以改善临床结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

HIV Medicine 医学-传染病学

CiteScore

5.10

自引率

10.00%

发文量

167

审稿时长

6-12 weeks

期刊介绍： HIV Medicine aims to provide an alternative outlet for publication of international research papers in the field of HIV Medicine, embracing clinical, pharmocological, epidemiological, ethical, preclinical and in vitro studies. In addition, the journal will commission reviews and other feature articles. It will focus on evidence-based medicine as the mainstay of successful management of HIV and AIDS. The journal is specifically aimed at researchers and clinicians with responsibility for treating HIV seropositive patients.