Drug-drug interactions based on pharmacogenetic profile between highly active antiretroviral therapy and antiblastic chemotherapy in cancer patients with HIV infection

Michele Caraglia, S. Zappavigna, A. Lombardi, Carla Fierro, Luigi Atripaldi, Tommaso Muto, Daniela Valente, Raffaele Di Francia

Research output: Contribution to journalReview articlepeer-review

Abstract

The introduction of Highly Active Antiretroviral Therapy (HAART) into clinical practice has dramatically changed the natural approach of HIV-related cancers. Several studies have shown that intensive antiblastic chemotherapy (AC) is feasible in HIV-infected patients with cancer, and that the outcome is similar to that of HIV-negative patients receiving the same AC regimens. However, the concomitant use of HAART and AC can result in drug accumulation or possible toxicity with consequent decreased efficacy of one or both classes of drugs. In fact, many AC agents are preferentially metabolized by CYP450 and drug-drug interactions (DDIs) with HAART are common. Therefore, it is important that HIV patients with cancer in HAART receiving AC treatment at the same time receive an individualized cancer management plan based on their liver and renal functions, their level of bone marrow suppression, their mitochondrial dysfunction, and their genotype profile. The rationale of this review is to summarize the existing data on the impact of HAART on the clinical management of cancer patients with HIV/AIDS and DDIs between antiretrovirals and AC. In addition, in order to maximize the efficacy of antiblastic therapy and minimize the risk of drug-drug interaction, a useful list of pharmacogenomic markers is provided.

Original languageEnglish
Article number71
JournalFrontiers in Pharmacology
Volume7
Issue numberMAR
DOIs
Publication statusPublished - Mar 30 2016

Keywords

  • AIDS
  • Antiblastic chemotherapy
  • Antiretroviral therapy
  • Cancer
  • HIV
  • Pharmacogenomics
  • Polymorphisms cytochrome P450

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology

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