Contemporary Drug-Drug Interactions in HIV Treatment

Clin Pharmacol Ther. 2019 Jun;105(6):1362-1377. doi: 10.1002/cpt.1393. Epub 2019 Mar 25.


Despite development of modern antiretrovirals with lower drug interaction potential than their predecessors, drug interaction challenges remain. Standard treatment regimens still require multiple antiretrovirals that may cause, or may be the target of, drug interactions. Additionally, people living with HIV are living longer and often present with comorbid conditions that require concomitant long-term drug therapy. Also, treatment of infectious diseases in resource-limited settings can result in significant interactions. In this review, we describe absorption, distribution, metabolism, and excretion pathways as they relate to relevant drug interactions with antiretrovirals along with the potential clinical consequences of these interactions. We highlight clinical data that illustrate pertinent interactions and provide tools to assist in predicting drug interactions in the absence of clinical data. Given these tools and thoughtful consideration of drug combinations, drug therapy in people living with HIV can be safely and effectively managed throughout their lifetime.

Publication types

  • Review

MeSH terms

  • Anti-HIV Agents / adverse effects
  • Anti-HIV Agents / metabolism*
  • Anti-Retroviral Agents / adverse effects
  • Anti-Retroviral Agents / metabolism*
  • Antihypertensive Agents / adverse effects
  • Antihypertensive Agents / metabolism
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / metabolism
  • Drug Interactions / physiology*
  • HIV Infections / drug therapy*
  • HIV Infections / metabolism*
  • Humans


  • Anti-HIV Agents
  • Anti-Retroviral Agents
  • Antihypertensive Agents
  • Antineoplastic Agents