Managing drug interactions between Hepatitis C direct acting antivirals and antiretroviral therapy

By:

• Elizabeth Sherman, PharmD, AAHIVP
  South Florida – Southeast AIDS Education and Training Center
• Joanne Orrick, PharmD, AAHIVP
  North Florida – Southeast AIDS Education and Training Center

The management of patients with hepatitis C virus (HCV) infection is rapidly evolving and is now centered on the use of direct acting antivirals (DAAs). With many recent DAA drug approvals along with a rich pipeline of investigational agents, it has become increasingly difficult for prescribers to keep up with drug interaction information. Table 1 below provides a list of FDA-approved DAAs for HCV infection. While concurrent treatment of HIV and HCV is feasible, it may be complicated by drugdrug interactions. The antiretroviral regimen may need to be modified before HCV treatment is initiated to reduce the potential for drug-drug interactions that may develop during the concurrent HIV and HCV treatment. Table 2 below provides recommendations on the concomitant use of selected drugs for treatment of HCV and HIV infection. Additional guidance on the treatment and management of HCV can be found at http://www.hcvguidelines.org/. Additional resources for HIV and viral hepatitis drug interaction information can be found at www.hep-druginteractions.org and www.hiv-druginteractions.org.