Table 2.
Summary of Recommended Antiretroviral Regimens by Drug Class and Potential Metabolic Considerations for Persons with HIV/HCV Co-infection
| Impact on Lipids |
Cardiovascular disease |
Liver disease | Kidney disease |
PK drug interactions |
|
|---|---|---|---|---|---|
| Nucleoside Reverse Transcriptase Inhibitors (NRTI) | |||||
| ABC/3TC | - | (X) | (X) in CTP B, C | - | - |
| TAF/FTC | ↓ | - | Active against Hepatitis B | - | - |
| TDF/FTC | ↑ | - | Active against Hepatitis B | (X) | - |
| Non-nucleoside Reverse Transcriptase Inhibitors (NNRTI) | |||||
| DOR | - | - | - | - | - |
| EFV | ↓ | - | - | - | Many DDIs possible* |
| RPV | - | - | - | - | (X) with acid-lowering agents |
| Protease Inhibitors (PI) | |||||
| ATV/c, ATV/r | ↓ | ↑ | Increases indirect hyper-bilirubinemia | May cause nephrolithiasis | (X) with acid-lowering agents |
| DRV/c, DRV/r | ↓ | (X) | - | - | Many DDIs possible* |
| Integrase Strand Transfer Inhibitors (INSTI) | |||||
| BIC | - | - | - | - | (X) coadministration with polyvalent cations |
| DTG | - | - | - | - | (X) coadministration with polyvalent cations |
| EVG/c | ↓ | - | - | - | Many DDIs possible* |
| RAL | - | - | - | - | (X) coadministration with polyvalent cations |
Abbreviations: 3TC = Lamivudine; ABC = Abacavir; ATV = Atazanavir; BIC = Bictegravir; CTP = Child Turcotte Pugh; c = Cobicistat; DDIs = Drug-drug interactions; DOR = Doravirine; DRV = Darunavir; DTG = Dolutegravir; EVG = Elvitegravir; FTC = Emtricitabine; PK = pharmacokinetic; r = Ritonavir; RAL = Raltegravir; RPV = Rilpivirine; TAF = Tenofovir Alafenamide Fumarate; TDF = Tenofovir Disoproxil Fumarate
Symbols: (X) = Avoid use; (--) = No reported association; ↑ = May benefit; ↓ = May worsen
*
Suggest referencing a medication interaction tool (i.e. https://www.hiv-druginteractions.org/)