Pioneering tools for managing drug-drug interactions in HIV and hepatitis
Drug-drug interactions (DDIs) pose a significant risk, affecting 25% of individuals on HIV treatment. To combat this, Professors Saye Khoo and David Back have developed innovative prescribing tools to identify and manage DDIs in HIV and hepatitis.
These resources have become standard care in over 30 countries. They successfully identify missed DDIs in up to 95% of prescriptions and alter clinical management in 55% of cases.
Identifying the risk
Recognising the critical danger of DDIs in HIV and hepatitis treatments, the team at Liverpool was the first to report harmful DDIs in HIV-TB co-infection, as well as the beneficial boosting of HIV protease inhibitors. Researchers participated in large-scale studies, which highlighted that significant DDIs affected 18-35% of patients on antiretrovirals. Leveraging their expertise, Professor Khoo and Professor Back launched an electronic HIV drug interaction tool in 2000, incorporating extensive drug information and systematic evidence evaluations.
The introduction of direct-acting antivirals (DAAs) for hepatitis C in 2011, despite their improved efficacy, presented new DDI challenges. Our researchers responded by developing hepatitis drug interaction tools, which were expanded to cover more hepatic diseases by 2019.
The tools developed at Liverpool are unparalleled, systematically evaluating over 80,000 DDIs and including a comprehensive database of co-medications, recreational drugs, and herbal therapies. The robust, transparent evidence evaluation ensures accurate and reliable drug information, which is continually updated with emerging data.
Incorporating the technology
Our suite of world-leading DDI tools in HIV and hepatology is accessible globally. Collaborating with patient advocacy groups, we can ensure the tools are user-friendly for healthcare professionals, researchers, and patients. These tools have a vast reach and influence, and their impact is profound.
They are incorporated into national and international health policies, recommended in HIV clinics across the UK, and widely used in Western Europe, North America, Latin America, Asia, and Africa. Our resources are foundational to the DDI sections of WHO and European treatment guidelines. As stated by the Chair of the WHO HIV Guideline Review Committee, the tools developed at Liverpool are "world-leading resources", essential for developing global HIV treatment guidelines.
Beyond prescribing support, our researchers also address knowledge gaps through educational events, including symposia at major conferences and virtual global workshops.
Economic benefits to healthcare systems
These tools deliver economic benefits by preventing harm and reducing healthcare costs. Cost savings can be substantial; avoiding contraindicated combinations in the UK alone is estimated to save approximately £1.8 million annually. In France, the estimated cost savings per individual over a year due to avoided DDIs is approximately £2,021.
Through pioneering research and comprehensive, accessible tools, we have significantly improved the management of DDIs in HIV and hepatitis, enhancing patient safety and delivering considerable economic benefits globally.