HIV management in Australia – Part 1

Case scenario

Marcus usually purchases his salbutamol inhaler from your pharmacy. Today he brings in a new prescription for Seretide (fluticasone + salmeterol) from his GP. You are aware that Marcus is prescribed Symtuza (darunavir + cobicistat + emtricitabine + tenofovir) by a different prescriber who is s100-accredited. You check for potential interactions and determine that co-administration of fluticasone with darunavir/ cobicistat may increase the risk of systemic corticosteroid effects, including iatrogenic Cushing’s syndrome.^9,14,24

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Introduction

Human immunodeficiency virus (HIV) has become a chronic treatable condition in Australia. It is managed with antiretroviral therapy (ART) prescribed by s100-accredited prescribers and available to be dispensed in community pharmacies. Treatment with ART can now be as simple as a single tablet each day; however, the wide variety of ART available, the ageing population, comorbidities and possible polypharmacy mean a pharmacist’s input is valuable in close monitoring of treatment regimens for potential interactions and side effects. Pharmacists are able to identify potential interactions, minimise polypharmacy and assist with the management of comorbidities. Pharmacists are also able to identify people living w