Drug interactions in the management of HIV infection: an update

Improvement in the availability of antiretroviral (ARV) therapy continues to reduce HIV morbidity and mortality. With more treatment choices and better accessibility, the extent of medication use among patients with HIV/AIDS continues to grow. ARV drugs are particularly prone to drug interactions as a consequence of their metabolic and pharmacokinetic properties. The recognition and management of drug interactions in patients on ARVs is a constant challenge to medical providers. Staying abreast of drug interaction knowledge is complicated by the rate at which new information becomes available through in vivo investigation, case reports and pharmacokinetic studies. In addition, distinguishing the clinical significance of an interaction is difficult due to the large interpatient variability in pharmacokinetics exhibited by most ARV agents. This review provides an update to a previous review article published in 2005, and is intended to improve the reader's knowledge of drug interactions in the management of HIV infection.