OBJECTIVES: The aim of this international multicentre study was to review potential drug-drug interactions (DDIs) for real-life coadministration of combination antiretroviral therapy (cART) and coronavirus disease 2019 (COVID-19)-specific medications. METHODS: The Euroguidelines in Central and Eastern Europe Network Group initiated a retrospective, observational cohort study of HIV-positive patients diagnosed with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Data were collected through a standardized questionnaire and DDIs were identified using the University of Liverpool's interaction checker. RESULTS: In total, 524 (94.1% of 557) patients received cART at COVID-19 onset: 117 (22.3%) were female, and the median age was 42 (interquartile range 36-50) years. Only 115 (21.9%) patients were hospitalized, of whom 34 required oxygen therapy. The most frequent nucleoside reverse transcriptase inhibitor (NRTI) backbone was tenofovir disoproxil fumarate (TDF)/tenofovir alafenamide (TAF) with lamivudine or emtricitabine (XTC) (79.3%) along with an integrase strand transfer inhibitor (INSTI) (68.5%), nonnucleoside reverse transcriptase inhibitor (NNRTI) (17.7%), protease inhibitor (PI) (13.7%) or other (2.5%). In total, 148 (28.2%) patients received COVID-19-specific treatments: corticosteroids (15.7%), favipiravir (7.1%), remdesivir (3.1%), hydroxychloroquine (2.7%), tocilizumab (0.6%) and anakinra (0.2%). In total, 62 DDI episodes were identified in 58 patients (11.8% of the total cohort and 41.9% of the COVID-19-specific treatment group). The use of boosted PIs and elvitegravir accounted for 43 DDIs (29%), whereas NNRTIs were responsible for 14 DDIs (9.5%). CONCLUSIONS: In this analysis from the Central and Eastern European region on HIV-positive persons receiving COVID-19-specific treatment, it was found that potential DDIs were common. Although low-dose steroids are mainly used for COVID-19 treatment, comedication with boosted antiretrovirals seems to have the most frequent potential for DDIs. In addition, attention should be paid to NNRTI coadministration.

4th Department Hospital for Infectious Diseases in Warsaw Warsaw Poland

Astar Medical Center Lviv Ukraine

Carol Davila University of Medicine and Pharmacy Victor Babes Clinical Hospital for Infectious and Tropical Diseases Bucharest Romania

Department for AIDS Specialized Hospital for Active Treatment of Infectious and Parasitic Disease Sofia Sofi Bulgaria

Department for Infectious Diseases Faculty of Medicine University of Banja Luka Republika Srpska Banja Luka Bosnia and Herzegovina

Department of Adults' Infectious Diseases Hospital for Infectious Diseases Medical University of Warsaw Warsaw Poland

Department of Infectious Diseases 1st Faculty of Medicine Charles University Prague and Faculty Hospital Bulovka Bulovka Czech Republic

Department of Infectious Diseases and Clinical Microbiology Faculty of Medicine Ege University Izmir Turkey

Department of Pharmacology Clinical Pharmacology and Toxicology School of Medicine University of Belgrade Belgrade Serbia

Faculty of Medicine in Plzeň Charles University University Hospital Plzeň Plzeň Czech Republic

Faculty of Medicine Vilnius University Vilnius University Hospital Santaros Klinikos Vilnius Lithuania

Global Fund Grant Management Department Republican Scientific and Practical Center for Medical Technologies Minsk Belarus

HIV Center National Institute of Hematology and Infectious Diseases South Pest Central Hospital Budapest Hungary

Infectious Disease Service University Hospital Center of Tirana Tirana Albania

Infectious Diseases AIDS and Clinical Immunology Center Tbilisi Georgia

Medical School National and Kapodistrian University of Athens University General Hospital Attikon Athens Greece

School of Medicine University Hospital for Infectious Diseases University of Zagreb Zagreb Croatia

Viral Hepatitis and AIDS Department at the Gromashevsky Institute of Epidemiology and Infectious Diseases Kyiv Ukraine

West Tallinn Central Hospital Tallinn Estonia

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