Retrospective Evaluation of an Observational Cohort by the Central and Eastern Europe Network Group Shows a High Frequency of Potential Drug–Drug Interactions Among HIV-Positive Patients Receiving Treatment for Coronavirus Disease 2019 (COVID-19)

Botond Lakatos; Justyna Kowalska; Sergii Antoniak; Deniz Gokengin; Josip Begovac; Anna Vassilenko; Piotr Wasilewski; Lukas Fleischhans; David Jilich; Raimonda Matulionyte; Kerstin Kase; Antonios Papadopoulus; Nino Rukhadze; Arjan Harxhi; Sam Hofman; Gordana Dragovic; Marta Vasyliev; Antonija Verhaz; Nina Yancheva; Cristiana Oprea


HIV Medicine. 2022;23(6):693-700. 

In This Article


Overall, 557 patients were included in the total cohort, among whom 524 were on cART at the time of onset of COVID-19 and hence were included in the current DDI analysis.

The typical patient profile was young (median age 42 years) and male (77.7%) with mild or asymptomatic COVID-19. Detailed patient demographics, and the clinical characteristics and outcomes are shown in Table 1. At the time of reporting, 465 (88.7%) patients had recovered completely, whereas 11 patients required intensive care unit admission and eight died.

With regard to HIV attributes, the median known duration of HIV infection was 8 [interquartile range (IQR) 4–13] years, and the median CD4 count was 626 (IQR 430–848) cells/μL. The majority of patients (463; 88.3%) had an undetectable HIV viral load. cART included mainly tenofovir disoproxil fumarate (TDF)/tenofovir alafenamide (TAF) with a lamivudine or emtricitabine (XTC) backbone, predominantly using integrase strand transfer inhibitors (INSTIs; 359; 68.5%), nonnucleoside reverse transcriptase inhibitors (NNRTIs; 93; 17.7%) and protease inhibitors (PIs; 72; 13.7%). COVID-19-specific treatments were administered to 148 (28.2%) patients with moderate or severe forms of the disease; this consisted of favipiravir (37; 7.1%), remdesivir (16; 3.1%) and hydroxychloroquine (14; 2.7%), whereas corticosteroids (82; 15.7%), tocilizumab (three; 0.6%), and anakinra (one; 0.2%) were used as immunomodulatory therapy.

Drugs taken by, or administered to, patients and the potential DDIs (according to the database) are listed in detail in Table 2. In total, 148 (28.2% of the whole cohort) patients received COVID-19-specific treatments and 62 potential DDIs were identified in 58 patients, which corresponds to 11.8% of the whole cohort and 41.9% of the COVID-19-specific treatment group. Use of dexamethasone, hydroxychloroquine, favipiravir and azithromycin showed potential interactions with boosted PIs/elvitegravir in 28.4% (n = 42) of ARTs and with NNRTIs in 9.5% (n = 14) of ARTs.