Study: HIV, Hep-C Medications Can Interact Adversely
A pair of University of Rhode Island researchers have found that hepatitis C and human immunodeficiency virus (HIV) medications can cause complications when used together to treat those co-infected with both infections.
While noting that medications used to treat hepatitis C have a high success rate, the authors have found that the hepatitis C drug sofosbuvir can interact adversely with tenofovir disproxil, a drug used to treat HIV.
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The investigators point out that common hepatitis C medications containing sofosbuvir are frequently used with additional medications in an effort to treat co-infections with other viruses such as HIV and hepatitis B.
In this study, however, the authors demonstrate that sofosbuvir inhibits the hydrolysis of tenofovir disoproxil, which has an irreversible impact on the drug-activating CES-2 enzyme. This decreases the therapeutic activation of tenofovir disoproxil, which has implications of increased kidney toxicity, according to the authors, who advise physicians to prescribe the medications with instructions to take them at different times or different routes. Noting that clinical trials are necessary in order to better evaluate the impact of combining these medications, the researchers also indicate that the HIV medication can be administered first or through the skin, with the hepatitis C medication taken orally at a later time.
The researchers note that further clinical trials should analyze the impacts of these medications when taken in combination, and that for now, they should be prescribed with recommendations to take them at different times or different routes.
—Mark McGraw
Reference
Shen Y, Yan B. Covalent inhibition of carboxylesterase-2 by sofosbuvir and its effect on the hydrolytic activation of tenofovir disoproxil [published online December 12, 2016]. Journal of Hepatology. DOI: http://dx.doi.org/10.1016/j.jhep.2016.11.025.