Date of Award
1-1-2014
Language
English
Document Type
Dissertation
Degree Name
Doctor of Philosophy (PhD)
College/School/Department
Department of Epidemiology and Biostatistics
Program
Epidemiology
Content Description
1 online resource (vi, 202 pages) : illustrations.
Dissertation/Thesis Chair
Louise-Anne McNutt
Committee Members
Christopher D Miller, Thomas P Lodise, Victoria Lazariu
Keywords
boceprevir, drug interactions, hepatitis, HIV, telaprevir, treatment, HIV infections, Hepatitis C, Serine proteinases, Drug interactions, HIV Infections, Serine Endopeptidases
Subject Categories
Epidemiology | Public Health
Abstract
This dissertation enhances our understanding of clinically significant drug-drug interactions (CSDDIs) and contraindicated drug interactions among patients with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) coinfection before and after the addition of HCV therapy including first generation non-structural (NS) 3A serine protease inhibitors. This is important to understand because the clinical sequelae of untreated chronic HCV infection are devastating yet drug-drug interactions greatly complicate treatment for these patients. The HIV/HCV coinfected population is a population that is particularly vulnerable because they are using a high volume of medications. Specifically, the standard of care for patients with HIV infection is the use of at least 3 antiretroviral agents. Many of the commonly used antiretroviral agents are processed by the cytochrome P450 (CYP450) isoenzyme system and are implicated in several drug interactions. Additionally, treatment of HCV infection involves the use of triple therapy including pegylated interferon, ribavirin and a direct acting antiviral (DAA) agent. Many DAAs are implicated in drug-drug interactions because they are also processed by the CYP450 isoenzyme system. Patients coinfected with HIV and HCV typically use at least 6 medications. Given the advances in treating HCV, this population is also developing age-related comorbidities which require medication-related intervention. This population is thus particularly vulnerable to CSDDIs.
Recommended Citation
Patel, Nimish, "Medication use and patients co-infected with Human Immunodeficiency Virus and Hepatitis C Virus : quantifying the prevalence and identifying the predictors of clinically significant drug-drug interactions associated with therapy containing first generation non-structural 3A serine protease inhibitors" (2014). Legacy Theses & Dissertations (2009 - 2024). 1230.
https://scholarsarchive.library.albany.edu/legacy-etd/1230