New Guidelines Issued For Prescribing Anti-Seizure Drugs For People With HIV/AIDS
Review Paper Identifies Significant Antiretroviral Drug Interaction Concerns
New guidelines issued by the American Academy of Neurology (AAN) recommends doctors use caution when choosing anti-seizure drugs for people with HIV/AIDS in order to avoid potential drug interactions. The guidelines were co-developed with the International League Against Epilepsy (ILAE) and published in the January 4th online issue of Neurology, as well as in Epilepsia, the Journal of the ILAE.
“A review of available literature showed significant evidence that certain antiepileptic drugs are likely to reduce the efficacy of antiretroviral medications used to treat HIV,” said Jacqueline A. French, MD, professor of neurology and director of translational research and clinical trials at the Comprehensive Epilepsy Center at NYU Langone Medical Center, and co-author of the new guidelines and past co-chair of the ILAE Commission on Therapeutic Strategies. “A reduction in antiretroviral efficacy can increase the likelihood of a patient developing resistance to that antiretroviral – which subsequently could be passed on to others.”
The guidelines include several key findings regarding the literature of anti-seizure medications and HIV/AIDS medications including:
- When certain seizure drugs are combined with specific HIV/AIDS drugs, one or more of the combined drugs may become less effective, or more toxic;
- Seizure drugs that decrease HIV/AIDS drug levels – such as phenytoin, phenobarbital and carbamazepine – may cause HIV/AIDS drugs to fail; and
- People with HIV/AIDS who also have seizures may possibly have fewer drug interactions if treated with the correct dosage of seizure drugs recommended by the new guidelines, which can be found at www.aan.com/guidelines.
According to the Center for Disease Control, at the end of 2008 there were an estimated 1,178,350 persons aged 13 and older living with HIV infection in the United States, with approximately 50,000 people newly infected each year. According to the AAN, seizures and seizure disorders are common in people infected with HIV, with more than one in 10 patients experiencing seizures.
Dr. French is an expert in the research and clinical care of seizures and epilepsy, including the use of electroencephalography (EEG) techniques as well as advances in antiepileptic drugs. She lectures around the world on topics related to antiepileptic drug therapeutics; has authored papers in journals such as Neurology, Epilepsia and New England Journal of Medicine; and serves as an ad hoc reviewer for many journals, including Epileptic Disorders, and on the editorial boards of Lancet Neurology and Neurotherapeutics.
The Comprehensive Epilepsy Center at NYU Langone Medical Center is among the largest epilepsy centers in the United States and designated a Level 4 Epilepsy Center by the National Association of Epilepsy Centers (NAEC). You can learn more at http://epilepsy.med.nyu.edu/.
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