New guidelines from the American Academy of Neurology will help physicians better choose seizure drugs for people on HIV/AIDS medication, avoiding deadly drug interactions and preventing critical anti-HIV drugs from becoming less effective, possibly leading to a more virulent strain of the disease.

-Team@CMHF

• Michigan State University’s Gretchen Birbeck – is doing research on epilepsy, HIV /AIDS and cerebral malaria – is the lead author of the medical guideline, which was co-developed with the World Health Organization through the International League Against Epilepsy.
• More than 33 million people worldwide were living with HIV in 2009.
• Seizure disorders are common among people with HIV, with up to 55 percent of patients requiring treatment with anti-epileptic drugs, known as AEDs, said Birbeck,
• Until now, formal treatment guidelines did not exist for those with HIV/AIDS who were in need of AEDs, which treat everything from epilepsy to mood disorders to other neurological ailments.
• When certain seizure drugs are combined with HIV/AIDS drugs known as antiretrovirals, or ARVs, 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.
• Drug interactions between AEDs and ARVs could result in progression to AIDS and/or reduced seizure control,said Birbeck,
• Providing guidelines that help physicians select appropriate therapies for their patients with epilepsy and HIV/AIDS will ultimately improve patient outcomes and possibly decrease the public health threat of the development of drug-resistant HIV.
• Because seizure and HIV/AIDS drug choices are limited in developing countries, the risk of drug interactions is higher in those countries.
• Future research should target epilepsy and HIV/AIDS drug combinations where choices are limited, such as in developing countries, to better understand the risks, said Birbeck
• Patients should know exactly which drugs they are taking and provide that information to all prescribing health care providers caring for them.
• To establish the guidelines, Birbeck and colleagues systematically reviewed studies published in the medical literature between 1950 and 2010 to determine the prevalence of co-usage of anti-epileptic drugs and antiretrovirals and drug interactions.
• Nearly 4,500 articles were identified, 68 full studies were reviewed and data from 42 used in the analysis.

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