The Conference started yesterday and I attended a very interesting workshop on the ongoing relevance of Drug Drug Interactions. The debate, which found ongoing interested and need for attention to drug drug interactions, gave way to three very important case disucssions about DDIs in the context of coinfection and comorbidities.
Sanjay Bhagani presented on the HIV/HCV coinfected patient. While a complex case it was illustrative of some of the issues in managing not just coinfected, but also HCV mono-infected patients and just how long it is safe to delay the commencement of treatment and how much DAAs can rescue patients with advanced liver disease. I am going to try and talk to him in more detail about this during the conference.
Marta Boffito presented on recreational drug interactions with HIV therapy and suggested that some presumed interactions could simply be poor dosing or understanding of the variability of rereational drugs on the part of the patient.
Lastly Kelly Dooley, reporting on TB HIV coinfection raised the issue of whether to treat TB before starting HIV Therapy. Cautioning that the emergence of multi drug and XDRTB suggests treating HIV at the same time. Fortunately we do not see a lot of TB in Australia, but with changing epidemiology this may become more important.