{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T05:08:59Z","timestamp":1788930539374,"version":"build-2803163510"},"reference-count":74,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Gilead Sciences","award":["300397FAC23"],"award-info":[{"award-number":["300397FAC23"]}]},{"award":["300397FAC23"],"award-info":[{"award-number":["300397FAC23"]}],"id":[{"id":"https:\/\/ror.org\/03hxqcn24","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmaceuticals"],"abstract":"<jats:p>Background\/Objectives: People Living with HIV (PLWH) often have comorbidities require polypharmacy, increasing the risk of adverse events (AEs) associated with drug\u2013drug\/drug\u2013supplement interactions (DDIs\/DSIs). However, DDIs and DSIs, including those involving antiretrovirals (ARVs), and their related effects have not been exhaustively assessed. This study aimed to determine, in HIV patients on HAART who are taking multiple medications, the prevalence of DDIs and DSIs involving both ARVs and non-ARV co-medications, and their clinical relevance and consequences. Methods: In this longitudinal observational study, PLWH receiving HAART were consecutively enrolled at the University Hospital of Salerno and followed up during scheduled visits. Demographic, clinical, and pharmacological data were collected. DDIs\/DSIs were identified using Drugs.com, Lexicomp, and the Liverpool HIV Interaction Checker. Interactions classified as major (Drugs.com), consider therapy modification or avoid combination (Lexicomp), and do not coadminister (Liverpool) were deemed highly clinically relevant. This assessment was supplemented with review of SmPCs and the available literature. Results: Among 84 PLWH, 229 interactions were identified, and 37\/229 (16.2%) were highly clinically relevant. Eight patients (9.5%) experienced AEs predicted by the tools. Four were DDIs: cobicistat\/alprazolam associated with sedation and dyspnoea, rilpivirine\/hydroxychloroquine with QT prolongation, bictegravir\/ursodeoxycholic acid with rising viremia, and atorvastatin\/fenofibrate with myalgia. Four DSIs between bictegravir and supplements containing divalent ions have been associated with increasing viremia. After medication review, alprazolam was replaced with zolpidem, rilpivirine-based HAART with bictegravir\/emtricitabine\/tenofovir alafenamide, and atorvastatin\/fenofibrate with simvastatin\/ezetimibe, and ursodeoxycholic acid and supplements were discontinued. These interventions were temporally associated with clinical improvement of interaction-related AEs and good virological control. Conclusions: This study highlights the importance of predicting DDIs\/DSIs in PLWH undergoing polypharmacy. Medication review supports clinical decision-making, preventing avoidable adverse outcomes.<\/jats:p>","DOI":"10.3390\/ph19091383","type":"journal-article","created":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T15:08:43Z","timestamp":1788275323000},"page":"1383","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Need for Medication Review and Deprescribing in People Living with HIV: A Longitudinal Observational Study"],"prefix":"10.3390","volume":"19","author":[{"given":"Emanuela","family":"De Bellis","sequence":"first","affiliation":[{"name":"PhD School \u201cClinical and Translational Oncology (CTO)\u201d, Scuola Superiore Meridionale, University of Naples \u201cFederico II\u201d, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8014-624X","authenticated-orcid":false,"given":"Danilo","family":"Donnarumma","sequence":"additional","affiliation":[{"name":"PhD School \u201cClinical and Translational Oncology (CTO)\u201d, Scuola Superiore Meridionale, University of Naples \u201cFederico II\u201d, 80138 Naples, Italy"},{"name":"Postgraduate School of Clinical Pharmacology and Toxicology, University of Salerno, 84081 Baronissi, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6516-2674","authenticated-orcid":false,"given":"Annarita","family":"Pagano","sequence":"additional","affiliation":[{"name":"Postgraduate School of Clinical Pharmacology and Toxicology, University of Salerno, 84081 Baronissi, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ines","family":"Mazza","sequence":"additional","affiliation":[{"name":"Postgraduate School of Clinical Pharmacology and Toxicology, University of Salerno, 84081 Baronissi, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5076-3220","authenticated-orcid":false,"given":"Bruno","family":"Charlier","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery and Dentistry \u201cScuola Medica Salernitana\u201d, University of Salerno, 84081 Baronissi, Italy"},{"name":"Clinical Pharmacology Unit, San Giovanni di Dio e Ruggi d\u2019Aragona University Hospital, 84131 Salerno, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"Madonia","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, San Giovanni di Dio e Ruggi d\u2019Aragona University Hospital, 84131 Salerno, Italy"},{"name":"Clinical Infectious Diseases Unit, San Giovanni di Dio e Ruggi d\u2019Aragona University Hospital, 84131 Salerno, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfonso","family":"Masullo","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, San Giovanni di Dio e Ruggi d\u2019Aragona University Hospital, 84131 Salerno, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirella","family":"Onofrio","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, San Giovanni di Dio e Ruggi d\u2019Aragona University Hospital, 84131 Salerno, Italy"},{"name":"Clinical Infectious Diseases Unit, San Giovanni di Dio e Ruggi d\u2019Aragona University Hospital, 84131 Salerno, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Fortunato","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, San Giovanni di Dio e Ruggi d\u2019Aragona University Hospital, 84131 Salerno, Italy"},{"name":"Clinical Infectious Diseases Unit, San Giovanni di Dio e Ruggi d\u2019Aragona University Hospital, 84131 Salerno, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Maria","family":"Spera","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, San Giovanni di Dio e Ruggi d\u2019Aragona University Hospital, 84131 Salerno, Italy"},{"name":"Clinical Infectious Diseases Unit, San Giovanni di Dio e Ruggi d\u2019Aragona University Hospital, 84131 Salerno, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Campana","sequence":"additional","affiliation":[{"name":"Department of Human, Philosophical and Formation Sciences, University of Salerno, 84084 Fisciano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3321-4331","authenticated-orcid":false,"given":"Gianluigi","family":"Franci","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery and Dentistry \u201cScuola Medica Salernitana\u201d, University of Salerno, 84081 Baronissi, Italy"},{"name":"Microbiology and Virology Unit, San Giovanni di Dio e Ruggi D\u2019Aragona University Hospital, 84131 Salerno, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flora","family":"Salzano","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery and Dentistry \u201cScuola Medica Salernitana\u201d, University of Salerno, 84081 Baronissi, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3441-889X","authenticated-orcid":false,"given":"Graziamaria","family":"Corbi","sequence":"additional","affiliation":[{"name":"Department of Translational Medical Sciences, University of Naples \u201cFederico II\u201d, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8235-9118","authenticated-orcid":false,"given":"Amelia","family":"Filippelli","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery and Dentistry \u201cScuola Medica Salernitana\u201d, University of Salerno, 84081 Baronissi, Italy"},{"name":"Clinical Pharmacology Unit, San Giovanni di Dio e Ruggi d\u2019Aragona University Hospital, 84131 Salerno, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8109-0655","authenticated-orcid":false,"given":"Pasquale","family":"Pagliano","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery and Dentistry \u201cScuola Medica Salernitana\u201d, University of Salerno, 84081 Baronissi, Italy"},{"name":"Clinical Infectious Diseases Unit, San Giovanni di Dio e Ruggi d\u2019Aragona University Hospital, 84131 Salerno, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6964-2739","authenticated-orcid":false,"given":"Valeria","family":"Conti","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery and Dentistry \u201cScuola Medica Salernitana\u201d, University of Salerno, 84081 Baronissi, Italy"},{"name":"Clinical Pharmacology Unit, San Giovanni di Dio e Ruggi d\u2019Aragona University Hospital, 84131 Salerno, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1525","DOI":"10.1016\/S0140-6736(13)61809-7","article-title":"The end of AIDS: HIV infection as a chronic disease","volume":"382","author":"Deeks","year":"2013","journal-title":"Lancet"},{"key":"ref_2","unstructured":"(2026, April 28). 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