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Managing Drug Interactions between Antiretrovirals and Opportunistic Infections in People with HIV

Emily Ott1, Kubwayo Kayihura Mike1, Karissa Grey1

  • 1Department of Clinical Pharmacy and Translational Science, College of Pharmacy, University of Tennessee Health Science Center, Memphis, USA.

Current HIV Research
|January 27, 2026
PubMed
Abstract

Insights

Treating opportunistic infections in people with HIV requires careful management of drug interactions between antiretrovirals and medications for infections. Vigilance for immune reconstitution inflammatory syndrome (IRIS) is crucial, especially with certain infections like cryptococcal meningitis.

Area of Science:

  • Infectious Diseases
  • Pharmacology
  • Immunology

Background:

  • Despite advances in HIV care, opportunistic infections remain a significant concern for individuals living with HIV.
  • Antiretroviral drugs used for HIV treatment can interact with medications prescribed for opportunistic infections, necessitating careful management.

Purpose of the Study:

  • To review opportunistic infections in people with HIV.
  • To examine drug interactions between antiretrovirals and treatments for opportunistic infections.
  • To discuss the mechanisms of these interactions and the risk of IRIS.

Main Methods:

  • A narrative review of relevant literature was conducted.
  • The review focused on medications for opportunistic infections and antiretrovirals in people with HIV.

Main Results:

  • Key opportunistic infections discussed include hepatitis B, hepatitis C, tuberculosis, cryptococcal meningitis, and pneumocystis pneumonia.
  • Potential and known drug interactions between antiretrovirals and treatments for these infections were identified.
  • Immune reconstitution inflammatory syndrome (IRIS) was discussed as a potential complication, particularly in patients with active opportunistic infections.

Conclusions:

  • While IRIS risk has decreased, it can still occur, especially with Cryptococcus neoformans infections.
  • Managing opportunistic infections in people with HIV demands significant expertise due to potential drug interactions.
  • Future strategies aim to simplify regimens and implement comprehensive management to reduce drug interactions and IRIS risk.
Keywords:
HIVantibioticantifungalantiretroviralantiviralopportunistic infection

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