HIV-positive patients are treated with various antiretroviral-containing drug combinations to control their underlying disease, which may also be combined with drugs aimed to manage independent or secondary comorbidities. This can expose patients to drug-drug interactions (DDIs) that may lead to suboptimal drug exposure, an increased risk of therapeutic failure or poor tolerability, and a need to adopt alternative therapeutic strategies. Although such undesired responses to pharmacological therapies can be appropriately managed in some situations, the fact that the available information is usually incomplete which makes it difficult (if not impossible) to assess DDIs and the consequent adjustments of polytherapies in clinical practice. For these reasons, we set up our ambulatory polytherapy management (Gestione Ambulatoriale Politerapie [GAP]) outpatient clinic in September 2016 to manage polypharmacy in HIV-infected patients. The main aims of the GAP clinic are to check whether patients are treated with drug combinations that are contraindicated due to known or predictable DDIs; assess the clinical and/or pharmacokinetic relevance of the DDIs; and provide written advice as to how the treatments should be modified if possible. We here describe the results of our 2-year experience in various clinical scenarios.

中文翻译：

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HIV病人中多药和药物相互作用的管理：2年多学科门诊诊所的经验

HIV阳性患者可以通过各种抗逆转录病毒药物组合治疗，以控制其潜在疾病，也可以将其与旨在治疗独立或继发合并症的药物联合使用。这会使患者暴露于药物-药物相互作用（DDI），这可能导致药物暴露不足，治疗失败或耐受性差的风险增加，以及需要采用其他治疗策略。尽管可以在某些情况下适当管理对药理疗法的这种不良反应，但事实是，可用信息通常不完整，这使得很难（如果不是不可能）评估DDI以及随后在临床实践中对多种疗法的调整。由于这些原因，我们于2016年9月成立了门诊多药治疗管理部门（Gestione Ambulatoriale Politerapie [GAP]）门诊，以管理HIV感染患者的多药治疗。GAP诊所的主要目的是检查患者是否因已知或可预测的DDI禁忌使用药物组合治疗；评估DDI的临床和/或药代动力学相关性；并就如何修改治疗方法提供书面建议。我们在这里描述了我们在各种临床情况下两年经验的结果。评估DDI的临床和/或药代动力学相关性；并就如何修改治疗方法提供书面建议。我们在这里描述了我们在各种临床情况下两年经验的结果。评估DDI的临床和/或药代动力学相关性；并就如何修改治疗方法提供书面建议。我们在这里描述了我们在各种临床情况下两年经验的结果。