Assessment of factors associated with potential drug-drug interactions in patients with tuberculosis and HIV/AIDS

Abstract

Introduction: The concomitant use of antituberculosis and antiretroviral drugs, as well as drugs to treat other diseases, can cause drug-drug interactions. This study aimed to describe potential drug-drug interactions (pDDI) in patients with TB and HIV/AIDS co-infection, as well as to analyze possible associated factors. Methods: This study was performed in a reference hospital for infectious and contagious diseases in the southeastern region of Brazil and evaluated adult patients co-infected with tuberculosis and HIV/AIDS. A cross-sectional study was conducted in which sociodemographic, clinical, and pharmacotherapeutic characteristics were assessed. The pDDI were identified using the Drug-Reax software. Association analysis was performed using either a chi-squared test or a Fisher's exact test. Correlation analysis was performed using the Spearman's coefficient. Results: The study included 81 patients, of whom 77 (95.1%) were exposed to pDDI. The most frequent interactions were between antituberculosis and antiretroviral drugs, which can cause therapeutic ineffectiveness and major adverse reactions. A positive correlation was established between the number of associated diseases, the number of drugs used, and the number of pDDI. An association was identified between contraindicated and moderate pDDI with excessive polypharmacy and hospitalization. Conclusions: We found a high frequency of pDDI, especially among those hospitalized and those with excessive polypharmacy. These findings highlight the importance of pharmacists in the pharmacotherapeutic monitoring in these patients.

Gerenciamento da terapia medicamentosa em pacientes com tuberculose e HIV/aids: série de casos

“…Pharmacotherapy is complex because it involves countless medications with clinically important and potential drug interactions, in addition to other associated diseases. 7,8 This case series is unique and, to our knowledge, it is the first study in which the researchers holistically monitored and assessed pharmacotherapy in patients co-infected with TB and HIV/AIDS. These patients present peculiar characteristics resulting from co-infection, as well as other clinical conditions that increase pharmacotherapy complexity and interfere with the treatment outcomes.…”

“…However, the number of published studies on pharmacotherapy monitoring in TB and HIV/ AIDS co-infection is low. 8,9 Medication Therapy Management (MTM) can reduce the impact of the TB and HIV/AIDS co-infection on public health, contributing to treatment effectiveness and safety. In this sense, this study aims at describing cases of co-infected patients exposed to the treatment recommended by the Ministry of Health for TB and HIV/AIDS and followed-up at a Reference Hospital in infectious diseases, in addition to identifying, classifying and solving the DRP outcomes, as well as the clinical and pharmacotherapeutic situation.…”