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)

Objectives The aim of this international multicentre study was to review potential drug–drug interactions (DDIs) for real‐life coadministration of combination antiretroviral therapy (cART) and coronavirus disease 2019 (COVID‐19)‐specific medications. Methods The Euroguidelines in Central and Eastern Europe Network Group initiated a retrospective, observational cohort study of HIV‐positive patients diagnosed with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection. Data were collected through a standardized questionnaire and DDIs were identified using the University of Liverpool's interaction checker. Results In total, 524 (94.1% of 557) patients received cART at COVID‐19 onset: 117 (22.3%) were female, and the median age was 42 (interquartile range 36–50) years. Only 115 (21.9%) patients were hospitalized, of whom 34 required oxygen therapy. The most frequent nucleoside reverse transcriptase inhibitor (NRTI) backbone was tenofovir disoproxil fumarate (TDF)/tenofovir alafenamide (TAF) with lamivudine or emtricitabine (XTC) (79.3%) along with an integrase strand transfer inhibitor (INSTI) (68.5%), nonnucleoside reverse transcriptase inhibitor (NNRTI) (17.7%), protease inhibitor (PI) (13.7%) or other (2.5%). In total, 148 (28.2%) patients received COVID‐19‐specific treatments: corticosteroids (15.7%), favipiravir (7.1%), remdesivir (3.1%), hydroxychloroquine (2.7%), tocilizumab (0.6%) and anakinra (0.2%). In total, 62 DDI episodes were identified in 58 patients (11.8% of the total cohort and 41.9% of the COVID‐19‐specific treatment group). The use of boosted PIs and elvitegravir accounted for 43 DDIs (29%), whereas NNRTIs were responsible for 14 DDIs (9.5%). Conclusions In this analysis from the Central and Eastern European region on HIV‐positive persons receiving COVID‐19‐specific treatment, it was found that potential DDIs were common. Although low‐dose steroids are mainly used for COVID‐19 treatment, comedication with boosted antiretrovirals seems to have the most frequent potential for DDIs. In addition, attention should be paid to NNRTI coadministration.