Management of the Patient With HIV/Hepatitis C Drug Interactions: A Guide for Nurses and Nurse Practitioners.
Laura E Starbird, Hyejeong Hong, Mark S Sulkowski and 1 others
PMID 31855873WHAT IT FOUND
Hepatitis C drugs can interact with HIV therapy.
Nurses should check the exact drug pair, coordinate any HIV switch before hepatitis C treatment, and monitor HIV viral load after the switch.
Key findings
01Sofosbuvir has the fewest interactions with HIV therapy, and reported interaction rates in people living with HIV range from 0% to 24%.
02Nurses should be prepared to initiate HIV therapy switches at least 1 month before a planned hepatitis C treatment start date.
03When HIV therapy is changed for hepatitis C treatment, hepatitis C drugs should start at least 2 weeks later and HIV viral load should be checked within 2 to 8 weeks.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This is a narrative guide, not a trial, so it does not test whether nurse-led coordination of HIV therapy changes improves hepatitis C outcomes. The article notes a paucity of evidence-based interventions to reduce the impact of HIV therapy and hepatitis C drug interactions. Hepatitis C drug approvals and HIV guidelines change quickly, so the named drug options and interaction advice may become outdated.
Declared interests
The article lists NIH extramural research support. Mark Sulkowski has been a paid consultant for AbbVie, Arbutus, Gilead, and Merck, and was principal investigator for research funded by AbbVie, Gilead, Proteus Digital Health, and Allergan with funds paid to Johns Hopkins University. The other authors report no conflicts.
The easy way to misread this
Do not read this as evidence that nurse-led HIV therapy switching has been tested and improves hepatitis C cure rates. The paper is a guide and says there is a paucity of evidence-based interventions for this problem.