CYP3A4 activity can be affected by multiple factors, including genetic polymorphisms, the presence of inhibitors or inducers, and environmental influences. Genetic variations can lead to differences in enzyme activity among individuals, impacting drug metabolism and response. Additionally, some compounds can inhibit or induce CYP3A4, affecting the metabolism of other drugs and potentially leading to drug interactions. Environmental factors such as diet and exposure to certain chemicals can also modulate enzyme activity.