Interactions between Hormonal Contraception and Anti-Retroviral Therapy: An Updated Review.

Interactions between Hormonal Contraception and Anti-Retroviral Therapy: An Updated Review.
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激素避孕与抗逆转录病毒疗法之间的相互作用:更新的评论。

DOI:
10.1007/s13669-020-00289-7
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发表时间:
2020-09
影响因子:
0.5
通讯作者:
Haddad LB
Haddad LB
中科院分区:
其他
文献类型:
--
作者:
Krishna GR;Haddad LB

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激素避孕使感染艾滋病毒的妇女有能力控制其生育能力,避免与怀孕有关的疾病。由于共同的代谢途径,人们一直担心激素避孕和抗逆转录病毒治疗之间的药物相互作用,这可能会影响药物的安全性和有效性。这篇文章的目的是提供一个更新的审查最新的数据围绕激素避孕药和抗逆转录病毒治疗。先前的数据表明,某些激素避孕药和抗逆转录病毒治疗之间可能存在药理学相互作用。最重要的相互作用包括孕激素避孕植入剂和依法韦仑之间的相互作用,以及联合激素避孕药和蛋白酶抑制剂之间的相互作用。然而,大多数过去的研究都具有小样本量的特点,很少有临床结果报告。自2017年以来的最新数据在很大程度上证实了先前关于这一主题的研究,显示了某些避孕药和抗逆转录病毒药物之间可能的药代动力学关系。值得注意的是,虽然孕激素避孕药的有效性,特别是植入剂,似乎随着依法韦仑的使用而降低,但总体有效性可能仍然高于大多数其他避孕方法。在改变避孕处方建议之前,需要更大规模的研究来提供进一步的指导。
Hormonal contraception provides women living with HIV the ability to control their fertility and avoid pregnancy-related morbidity. Due to shared metabolic pathways, there has been concern over drug-drug interactions between hormonal contraception and anti-retroviral therapy, which may affect the drugs’ safety and efficacy. This article aims to provide an updated review of the most recent data around hormonal contraceptives and anti-retroviral therapy. Prior data have suggested possible pharmacologic interactions between certain hormonal contraceptives and anti-retroviral therapy. The most significant interactions implicated include those between progestin-based contraceptive implants and efavirenz as well as between combined hormonal contraceptives and protease inhibitors. Most past studies, however, feature small sample sizes with few clinical outcomes reported. Recent data since 2017 have largely affirmed prior studies on this topic, showing possible pharmacokinetic relationships between certain contraceptives and anti-retrovirals. Notably, while the effectiveness of progestin-based contraceptives, specifically the implant, appears reduced with efavirenz use, the overall effectiveness may remain higher than most other contraceptive methods. Larger studies are needed to provide further guidance before contraceptive-prescribing recommendations can be changed.
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