Date of Award




Document Type


Degree Name

Doctor of Philosophy (PhD)


Department of Epidemiology and Biostatistics



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


boceprevir, drug interactions, hepatitis, HIV, telaprevir, treatment, HIV infections, Hepatitis C, Serine proteinases, Drug interactions, HIV Infections, Serine Endopeptidases

Subject Categories

Epidemiology | Public Health


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.

Included in

Epidemiology Commons