Occurrence Of Drug Interactions Research Articles

KAJIAN POTENSI INTERAKSI OBAT PADA PASIEN GERIATRI DENGAN GAGAL JANTUNG DI RSUD Dr. MOEWARDI SURAKARTA TAHUN 2023

Geriatric patients with heart failure generally receive more than 1 type of drug therapy, called polypharmacy, which typically involves at least four types of treatment: ACEI (Angiotensin Converting Enzyme Inhibitors), diuretics, beta blockers, and digoxin. This causes an increase in the occurrence of drug interactions. This study aims to determine the potential drug interactions that occur in geriatric patients with heart failure who undergo hospitalization at Dr. Moewardi Surakarta Hospital from January to December 2023. This study is a descriptive observational study with a cross-sectional design, and the data were collected retrospectively using a purposive sampling technique based on the medical records of geriatric patients at Dr. Moewardi Surakarta Hospital in 2023. The inclusion criteria were inpatients aged ≥55 years who were diagnosed with heart failure. The exclusion criteria were patients with incomplete or illegible medical record data or who died during treatment. Drug interaction research was conducted based on Drugs.com and Medscape. The results showed that out of the 100 patients, 98 experienced drug interactions. The incidence of drug interactions was 252 minor cases (21.65%), 818 moderate cases (69.50%), and 106 major cases (9.00%). The mechanism of drug interaction was pharmacodynamic in 919 cases (65.50%), pharmacokinetic in 213 cases (30.40%), and unknown in 44 cases (4.10%).

A cross-sectional study to determine the potential drug–drug interactions in patients with alcoholic liver disease in a tertiary care hospital

Background: Alcoholic liver disease (ALD) is a major cause of chronic liver disease worldwide, and it significantly contributes to liver-related mortality on a global scale. These patients often require drug treatment either for liver disease and its complications or for other comorbid conditions. Due to compromised hepatic function and the prevalence of polypharmacy-associated comorbidities, liver disease significantly increases the risk of drug-drug interactions (DDIs) and adverse drug reactions (ADRs). Aims and Objectives: The aim of the study was to determine the potential drug interactions in the pharmacological management of patients with alcoholic liver disease undergoing conservative treatment. Materials and Methods: A descriptive and cross-sectional study was conducted at Victoria Hospital attached to Bangalore Medical College and Research Institute over a period of 3 months. The study analyzed 200 cases of alcoholic liver disease for the presence of potential drug interactions using the LEXICOMP computer program. Results: The study included 200 subjects with alcoholic liver disease. About 92% were males, and 35% were from the age group of 41 to 50 years followed by 28% from 31 to 40 years. Cirrhosis was identified in 53% of the cases. The median number of drugs per patient was 8.8. A total of 118 potential DDIs (pDDIs) were identified averaging 2.5 pDDIs per patient. The common pDDIs were seen with ondansetron, metronidazole, propranolol, rifaximin, and ranitidine. It was noted that polypharmacy exhibited a robust association with the occurrence of drug interactions. The findings highlight a significant association between polypharmacy and the incidence of pDDIs. Conclusion: The complexity of pharmacotherapy in alcoholic liver disease stems from compromised liver function. It is crucial for physicians to be cognizant of the significant DDIs associated with medications used in liver disease treatment, given the heightened susceptibility of these patients to ADRs.

Rationality of the Antibiotics Use in Pediatric Acute Respiratory Infection Patients at Ssma Hospital in Pontianak, Indonesia

Acute respiratory tract infections (ARI) in children have a high prevalence that can be caused by bacteria or viruses. Antibiotics are prescribed more often than recommendations in the guidelines. This study aims to evaluate the rationality of antibiotic use and the occurrence of drug interactions in pediatric patients diagnosed with ARI at one of the hospitals in Pontianak based on some parameters such as right drug, right dose, and right duration as well as the incidence of drug interactions. Data collection was carried out based on medical record data which was carried out with a total sampling technique, namely taking all data that met the inclusion criteria.This research is a descriptive cross sectional design and retrospective data collection using patient medical records. Samples were taken by total sampling method. The results obtained from 131 patients consisting of 172 visits, right drug (131), right dose (93), and right duration (77).

A Review of the Development of Multitarget Molecules against HIV-TB Coinfection Pathogens.

The human immunodeficiency virus (HIV) produces the pathologic basis of acquired immunodeficiency syndrome (AIDS). An increase in the viral load in the body leads to a decline in the number of T lymphocytes, compromising the patient's immune system. Some opportunistic diseases may result, such as tuberculosis (TB), which is the most common in seropositive patients. Long-term treatment is required for HIV-TB coinfection, and cocktails of drugs for both diseases are used concomitantly. The most challenging aspects of treatment are the occurrence of drug interactions, overlapping toxicity, no adherence to treatment and cases of resistance. Recent approaches have involved using molecules that can act synergistically on two or more distinct targets. The development of multitarget molecules could overcome the disadvantages of the therapies used to treat HIV-TB coinfection. This report is the first review on using molecules with activities against HIV and Mycobacterium tuberculosis (MTB) for molecular hybridization and multitarget strategies. Here, we discuss the importance and development of multiple targets as a means of improving adherence to therapy in cases of the coexistence of these pathologies. In this context, several studies on the development of structural entities to treat HIV-TB simultaneously are discussed.

A Prospective Study of Medication Surveillance of a Pediatric Tertiary Care Hospital in Lahore, Pakistan.

Purpose: Several studies have shown that polypharmacy is the main cause of drug interactions, and the prevalence and the level of the severity varied with the duration of stay in the hospital, sex and race of the patients. The aims of this investigation were to identify the drug-drug interactions in hospitalized pediatric patients associated with polypharmacy, and to categorize the drug interactions in pharmacokinetic or pharmacodynamic interactions according to their level of severity. Methods: A cross-sectional, prospective analytical study was performed at a pediatric tertiary care hospital in Lahore, Pakistan for the duration of 4 months, which included prescription orders for 300 patients. Data were collected from patient medical files about previous and current medication history. Drug interactions were analyzed using interaction checker on Medscape and categorized according to the severity levels. Results: Out of 300 patients, the occurrence of drug interactions was found in 157 (52.3%) patients, while in 143 (47.7%), no interaction was found. Among these interactions, 50.7% were pharmacodynamic interactions, and 49.30% were pharmacokinetic interactions. Eighty-one percent of prescription orders with drug interactions contained more than three drugs, and 11.9% of interactions were severe. The majority of interactions were of amikacin-vancomycin, piroxicam-captopril and captopril-ciprofloxacin. Conclusion: Most of the interactions were moderate among patients with multiple drug prescriptions. The drug interactions can be minimized by providing special patient monitoring and adequate management with prior knowledge of these drug interaction.

Adverse Drug Reactions of Acetylcholinesterase Inhibitors in Older People Living with Dementia: A Comprehensive Literature Review.

The rising of global geriatric population has contributed to increased prevalence of dementia. Dementia is a neurodegenerative disease, which is characterized by progressive deterioration of cognitive functions, such as judgment, language, memory, attention and visuospatial ability. Dementia not only has profoundly devastating physical and psychological health outcomes, but it also poses a considerable healthcare expenditure and burdens. Acetylcholinesterase inhibitors (AChEIs), or so-called anti-dementia medications, have been developed to delay the progression of neurocognitive disorders and to decrease healthcare needs. AChEIs have been widely prescribed in clinical practice for the treatment of Alzheimer’s disease, which account for 70% of dementia. The rising use of AChEIs results in increased adverse drug reactions (ADRs) such as cardiovascular and gastrointestinal adverse effects, resulting from overstimulation of peripheral cholinergic activity and muscarinic receptor activation. Changes in pharmacokinetics (PK), pharmacodynamics (PD) and pharmacogenetics (PGx), and occurrence of drug interactions are said to be major risk factors of ADRs of AChEIs in this population. To date, comprehensive reviews in ADRs of AChEIs have so far been scarcely studied. Therefore, we aimed to recapitulate and update the diverse aspects of AChEIs, including the mechanisms of action, characteristics and risk factors of ADRs, and preventive strategies of their ADRs. The collation of this knowledge is essential to facilitate efforts to reduce ADRs of AChEIs.

Drug interactions for elderly with respiratory disorders and times of COVID-19: a systematic scoping review

Background: The elderly people have high morbimortality associated with respiratory disorders, in addition to the presence of other safety risk factors, such as the use of potentially inappropriate medication and the occurrence of drug interactions. Objective: Considering the current pandemic scenario, it was intended to identify explicit criteria-based tools that reported drug interactions between potentially inappropriate medication and respiratory system disorders and possibly worse prognosis of COVID-19 infection. Methods: A systematic scoping review was conducted until February 2020. Study characteristics of explicit criteria-based tools, and potentially inappropriate medication, drug interactions, and therapeutic management, were extracted. Results: Nineteen explicit criteria-based tools were included. Nineteen drug interactions and 17 potentially inappropriate medications with concerns for three respiratory disorders (asthma, chronic pulmonary obstructive disease, and respiratory failure) were identified. The most frequent pharmacological classes reported were benzodiazepines and beta-blockers. For clinical management, the tools recommend using cardioselective beta-blockers, calcium channel blockers, angiotensin-converting enzyme inhibitors, and angiotensin II type I receptor blockers, and benzodiazepines with a short or intermediate half-life. Conclusion: Considering the increased risk of COVID-19 infection in the elderly, drug interactions and the use of potentially inappropriate medication associated with the occurrence of adverse drug events in the respiratory system may also worsening COVID-19 infection in patients with uncontrolled respiratory disorders. Thus, it is essential to assess drug therapy in use, to identify safety risks, and monitor the elderly in general and those with a worse prognosis concerning COVID-19, promoting patient safety.

ASSESSMENT OF DRUG INTERACTIONS AMONG HOSPITALIZED PATIENTS AT HUE UNIVERSITY OF MEDICINE AND PHARMACY HOSPITAL

Background: Drug - drug interaction is a common problem in clinical practice, especially in comorbidity and multiple symptoms, the combination of drugs in treatment is inevitable. According to a literature review published in 2007, an estimated 0.6% of patients were hospitalized and about 0.1% of patients were re-hospitalized due to adverse drug reactions related to drug interactions. Objectives: (1) To identify clinically significant drug interactions among hospitalized patients at Internal Medicine Faculty, Hue University of Medicine and Pharmacy Hospital, (2) To build a management guideline of clinically significant drug interactions at Internal Medicine Faculty, Hue University of Medicine and Pharmacy Hospital. Materials and methods: 400 inpatient medical records in the Department of General Internal Medicine - Endocrinology and Cardiology Department were collected at the Department of General Planning, Hue University of Medicine and Pharmacy Hospital from April 1, 2019 to December 31, 2019; using cross-sectional descriptive study method. Results and Conclusion: The list of 20 clinically significant drug interaction pairs was identified and a management guideline for each interacting pair was built. The incidence of clinically significant drug interactions was 20.25%. The most commonly identified drug interaction pair was ACE inhibitors and potassium (7.50%). The occurrence of drug interactions increased with increase in the age of patients, the number of diseases, the duration of treatment and the number of drugs prescribed (p < 0.05). Key words: combination of drugs, drug interaction, clinically significant, medical record, inpatient

A Study on Detection of Drug-Laboratory interactions in Dermatology, in a Tertiary Care Teaching Hospital

Background: An interaction is alleged to occur once the consequences of one drug is changed by the presence of another drug, herbal medicine, food, drink or by some environmental chemical agents. As per American psychological association drug interaction is defined as chemical or physiological reaction that can occur when two different drugs are taken together. Objective: This study was conducted for the detection of various drug interactions in dermatology in a tertiary care teaching hospital. Methods: An observational, prospective study was conducted for a period of six months (July 2017 to December 2017) among 108 patients in dermatology department of Santhiram Medical College and General Hospital, Nandyal. Results: A total of 108 patients were included in the study. Among them, 63 (58.3%) were males and 45(41.7%) were females. Of total 108 prescriptions, sever drug-drug interactions were present in 42 (38.9 %) prescriptions. Whereas, moderate drug-drug interactions were found in 14 (13%) and 52 prescriptions doesn’t have drug-drug interactions respectively. The study found the associations of potential drug interactions with age, sex, number of drugs per prescription. There was a direct link between polypharmacy and occurrence of drug interactions. To lower the frequency of potential interactions it could be necessary to make a careful selection of therapeutic alternatives, and in cases without other options, patients should be continuously monitored to identify adverse events. Conclusion: we concluded that educational interventions can minimize the incidence of drug interactions.

Evaluation of Potential Drug-Drug Interactions with Medications Prescribed to Geriatric Patients in a Tertiary Care Hospital.

Background and Objectives The drugs most commonly implicated in major potential interactions are those used in the day-to-day clinical management of elderly patients with chronic diseases. This study is planned to evaluate the profile of drug-drug interactions in the medications prescribed to elderly population and also to identify the possible predictors for potential drug-drug interactions in the elderly. Methods This cross-sectional study included patients aged above 60 years with a minimum of two drugs in the prescriptions. Data were collected from medical prescriptions and patients' medical records. The data collected included demographic characteristics such as age, gender, height, weight, educational status, socioeconomic status, medical history, and medications prescribed. The prescriptions were analyzed for the potential drug interactions using Lexi-Interact™ Online, an online software to check drug-drug interactions. Results A total of 209 patients were included in the study, among them 104 (49.8%) were males and 105 (50.2%) were females. The mean number of medications received was 6.53 ± 2.15 per prescription. Around 138 (66%) patients received more than six medications. The mean number of potential drug interactions seen in the prescription of these patients was 3.17 ± 2.78. Around 18.2% patients had more than five drug interactions. Major drug interactions were observed in 21.42% of cases. Around 3.02% of drug interactions belonged to risk category X, i.e., to be avoided. Logistic regression analysis showed that age above 70 years was associated with the presence of drug interactions. Increased number of medication was independently associated with the occurrence of drug interactions. The presence of drug interactions was not associated with increased number of comorbidities. Conclusion A significant number of potential drug-drug interactions were seen in the prescriptions of elderly patients. Increasing age and polypharmacy were identified as the predictors of potential drug interactions.

ASSESSMENT OF DRUG INTERACTIONS IN OUTPATIENT PRESCRIPTIONS IN HUE UNIVERSITY OF MEDICINE AND PHARMACY HOSPITAL

Background: The combination of drugs in treatment is inevitable, especially in multiple diseases and multiple symptoms. This is the leading cause of occurrence of drug - drug interactions. Objectives: (1) To identify clinically significant drug interactions in outpatient prescriptions in Hue University of Medicine and Pharmacy Hospital, (2) To build a management guideline of clinically significant drug interactions in Hue University of Medicine and Pharmacy Hospital. Materials and methods: 5338 outpatient prescriptions were collected from Pharmacy Faculty – Hue University of Medicine and Pharmacy Hospital from 1st to 31st October 2017, using cross-sectional descriptive study method. Results and Conclusion: The list of 20 clinically significant drug interaction pairs was identified and a management guideline for each interacting pair was built. The prevalence of prescriptions with drug interactions was 6.7%. The most commonly identified drug interaction pair was clopidogrel and proton pump inhibitor (1.59%). The occurrence of drug interactions increased with increase in the age of patients and the number of drugs prescribed (p < 0.05). Key words: combination of drugs, drug interaction, clinically significant, prescription, outpatient

Hampered binding to blood serum albumin and antimicrobial activity of ibuprofen immobilised on magnetic nanoparticles Fe 3 O 4

Drug distribution in an organism depends largely on the binding degree of drugs with blood serum proteins like albumin. Only free fraction of the drug can induce a therapeutic effect. A different affinity of particular drugs to proteins is also one of the reasons of the occurrence of drug interactions. It was decided to investigate if the immobilisation of some model drugs on ‘magnetic nanoparticles Fe3O4 (MNPs)’ would influence their activity and protect from binding to albumin. It was proposed to attach the drugs such as ibuprofen (IB), acetylsalicylic acid and naproxen to the MNPs coated with ‘(3-aminopropyl)triethoxysilane’ by electrostatic interaction since carboxyl groups of the drugs can form ionic bonds with amino groups of the silane. The characterisation of morphology of the obtained nanostructures was also carried out. The drug release studies showed very slow diffusion of the drugs from the MNPs surface. It has been demonstrated that IB immobilised on MNPs exhibits high antimicrobial activity even in its low concentration and in the presence of albumin – in contrast to the unattached form of the drug.

Potential drug-drug interactions among elderly patients admitted to medical ward of Ayder Referral Hospital, Northern Ethiopia: a cross sectional study.

BackgroundThe elderly are considered as special population, as they differ from younger adults in terms of comorbidity, polypharmacy, pharmacokinetics, vulnerability to drug–drug interactions and adverse drug reactions. Despite the fact that the elderly patients are at high risk of having drug interaction and potential adverse outcomes, studies in this regard are scarce in resource limited settings like Ethiopia. The aim of this study was to assess the prevalence and determinants of potential drug–drug interaction in elderly patients admitted to medical ward of Ayder Referral Hospital in Northern Ethiopia.MethodsA cross sectional study was conducted among elderly inpatients aged 60 years and above. The study was conducted from February to May 2014. Prescribed drugs being taken concurrently for at least 24 h were included and checked for drug–drug interaction using Micromedex® 2.0 online drug reference. Data were analyzed using statistical software, statistical package for social sciences for windows version 20. Logistic regression model was used to analyze factors associated with occurrence of drug interaction. P value of <0.05 was considered statistically significant.ResultsA total of 140 patients were participated in the study. The mean age (±standard deviation) of participants was 68 (±7) years. Majority (61.4 %) of patients were diagnosed with cardiovascular and/or renal diseases. A total of 814 drugs were prescribed with a mean of 6 (±4) medications per patient during a 13 (±9) days of hospital stay. About two-third (62.2 %) of the respondents were exposed to at least one potential drug–drug interaction. Among these 3.6, 32.9 and 25.7 % of patients had taken contraindicated drug combination, at least one major and at least one moderate drug–drug interaction, respectively. Patients with five or more prescribed medications were four times at risk of having drug–drug interaction (P = 0.00; adjusted odds ratio 4.047; 95 % confidence interval 1.867–8.775).ConclusionDrug–drug interaction in elderly patients was common in this resource limited set-up. Awareness creation and clinical pharmacist involvement in minimizing the risk associated with potentially harmful drug combinations are needed.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-016-2238-5) contains supplementary material, which is available to authorized users.

Avaliação de interações medicamentosas potenciais em prescrições da atenção primária de Vitória da Conquista (BA), Brasil

Drug interactions are risk factors for the occurrence of adverse drug reactions. The risk for drug interactions includes factors related to prescription that are intrinsic to the patient. This study sought to evaluate the potential drug interactions in primary care prescriptions in Vitória da Conquista in the state of Bahia to fill the knowledge gap on this topic in Brazil. Information about several variables derived from the primary health care prescriptions was collected and drug interactions were evaluated based on information from Medscape and Micromedex(R) databases. Polypharmacy frequency and its association with the occurrence of drug interactions were also evaluated. Results revealed a 48,9% frequency of drug interactions, 74,9% of moderate or greater severity, 8,6% of prescriptions in polypharmacy that in the chi-square test showed a positive association with the occurrence of drug interactions (p < 0,001). Prescriptions from primary care in Vitória da Conquista in the state of Bahia showed a high frequency of drug interactions, however it is necessary to analyze other risk factors for their occurrence at this level of health care.

Recurrence of Panic Attacks After Brucellosis Treatment—Highly Probable Citalopram and Rifampin Drug Interaction

Recurrence of Panic Attacks After Brucellosis Treatment—Highly Probable Citalopram and Rifampin Drug Interaction

Drug therapy in patients with Parkinson’s disease

Parkinson`s disease (PD) is a progressive, disabling neurodegenerative disorder with onset of motor and non-motor features. Both reduce quality of life of PD patients and cause caregiver burden. This review aims to provide a survey of possible therapeutic options for treatment of motor and non motor symptoms of PD and to discuss their relation to each other. MAO-B-Inhibitors, NMDA antagonists, dopamine agonists and levodopa with its various application modes mainly improve the dopamine associated motor symptoms in PD. This armentarium of PD drugs only partially influences the onset and occurrence of non motor symptoms. These PD features predominantly result from non dopaminergic neurodegeneration. Autonomic features, such as seborrhea, hyperhidrosis, orthostatic syndrome, salivation, bladder dysfunction, gastrointestinal disturbances, and neuropsychiatric symptoms, such as depression, sleep disorders, psychosis, cognitive dysfunction with impaired execution and impulse control may appear. Drug therapy of these non motor symptoms complicates long-term PD drug therapy due to possible occurrence of drug interactions, - side effects, and altered pharmacokinetic behaviour of applied compounds. Dopamine substituting compounds themselves may contribute to onset of these non motor symptoms. This complicates the differentiation from the disease process itself and influences therapeutic options, which are often limited because of additional morbidity with necessary concomitant drug therapy.

Pharmaceutical care to patients treated with antidepressants

Depression is considered one of the ten most disabling conditions on the planet, causing physical, personal and social limitations. Antidepressants are the most commonly used drug treatment for eliminating or controlling the symptoms of depression. A variety of factors can contribute to treatment abandonment, particularly severe side effects. The present article is aimed to provide information and guidelines on the development of a pharmacotherapy follow-up program for patients treated with antidepressant medication. According to this practice, the pharmacist evaluates whether the three following requirements of a proper pharmacotherapy are being observed: need, effectiveness and safety. If one of these requirements is not met, the pharmacist seeks to solve the problem, by intervening in the pharmacotherapy, within the scope of his/her skills. Pharmaceutical care is aimed to improve adherence to treatment and minimize side effects, as well as the occurrence of drug interactions. Thus, the present article presents and discusses the main strategies of pharmaceutical care to achieve the proposed objectives.

Legemiddel­interaksjoner hos sykehuspasienter – forekomst og klinisk betydning

Introduction: Little is known about the occurrence of drug interactions of hospitalised patients. We aimed to identify the frequency of potential drug interactions among hospitalised patients and, furthermore, to evaluate how many of these were problematic and clinically significant. Methods: We investigated drug interactions by two methods: by applying a computerised drug-drug interaction programme and by prospective clinical evaluation. The study was carried out at departments of internal medicine and rheumatology in five Norwegian hospitals in 2002. Patient characteristics and information on drug use were recorded for 827 patients consecutively included. Medication reviews were carried out by clinical pharmacists and drug-related problems (DRPs), among which drug interactions is one category, were identified and discussed in the hospital multidisciplinary team, chaired by a physician. Retrospectively, the patients’ drug regimens were screened by using a computer programme for drug-drug interactions, DRUID. This programme is universally used in Norway and classifies DDIs into four categories according to assumed severity: A, avoid; B, avoid/take precautions; C, take precautions; D, no action needed. Results: A total of 1513 DDIs were found in 544 patients (66% of the total sample of 827 patients) by computer screening. Many of these were related to drugs started in the hospital, that is they were new drug interactions. By bedside evaluation, 99 DDIs were found in 73 patients (9%). Of these, 89 were also identified by computer screening. Thus, only 6% of the computer identified drug interactions were assessed to be clinically problematic. Interactions of all degrees of severity, according to the computer programme, were identified as problematic by bedside screening. Drugs most often causing new drug interactions were warfarin, acetylsalicylic acid, digitoxin and combinations of codeine and paracetamol. Conclusions: The majority of hospitalised patients have potential drug interactions, however, less than one in ten have interactions of clinical importance. Computer graded severity has limitations when intended to be used as an indicator for clinical importance. Another way of picking up new, possibly serious drug interactions would be to select indicator drugs, which are drugs frequently known to be involved in interactions, and then undertake the main interaction search on these drugs.

Potential drug interactions in intensive care patients at a teaching hospital

This study assessed potential drugs interactions in intensive care patients at a university hospital in Ceará, northeast Brazil. Of 102 patients studied, 72.5% were exposed to 311 potential drug-drug interactions; 64% of them were females aged 60 years or more and hospital stay was at least 9 days. A statistically significant association was found between number of drugs used and the occurrence of drug interactions. A total of 1,140 drugs were scheduled to be administered concomitantly; of these, 74% had potential for drug interactions. As for the classification of these events, 48.2% had a pharmacokinetic profile; 55.4% were of slow onset; 54.7% had moderate severity; and 60.6% were well-documented in the literature. The most common clinical action taken was 'to monitor signs and symptoms'. Nursing staff can perform 80% of preventive actions to avoid undesirable effects of drug interactions. However, nurses need to have adequate knowledge about drug action mechanisms and triggering factors associated to drug interactions.

Hcv Treatment Challenges in Patients Co-Infected with HIV

Infection with HCV is one of the most challenging co-morbidities emerging in HIV-infected patients in the post-antiretroviral therapy era. The co-infected population differs from the HCV mono-infected population in several aspects. HIV accelerates hepatic fibrosis progression, cirrhosis, end-stage liver disease, the development of hepatocellular carcinoma and death. Co-infected patients have a lower likelihood of achieving sustained virological response to treatment compared with mono-infected ones. A growing number of co-infected patients have a past history of nonresponse or relapse along with advanced liver disease. The simultaneous treatment of HCV and HIV may be associated with the occurrence of drug interactions, overlapping toxicities, and increased incidence and severity of side effects. This population is sorely in need of treatment. State-of-the-art management requires different strategies to achieve a cure with minimal adverse events. This review focuses on specific treatment challenges encountered in the current treatment of HCV in HIV-seropositive individuals.