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| Figure 1: Schematic representation of potential CYP3A4-mediated drug interactions with newly developed drugs CCR5 antagonists and integrase inhibitors (INIs) in HIV-positive patients. Exposure to drugs of abuse (DA), protease inhibitors (PIs), therapy or anti-hepatitis C virus medication can alter the expression and/or activity of CYP3A4 enzyme. Induction of CYP3A4 would result in increased metabolism of CCR5 antagonists/INIs, leading to potentially decreased response to these drugs and toxic buildup of metabolites. Inhibition of CYP3A4, on the other hand, would lead to decreased metabolism of CCR5 antagonists/INIs, potentially causing drug overdose-mediated toxicity. |
