Incidence and risk factors for liver enzyme elevation among naive HIV-1-infected patients receiving ART in the ICONA cohort
| Autor: | Taramasso, L., Lorenzini, P., Di Biagio, A., Lichtner, M., Marchetti, G., Rossotti, R., Lapadula, G., Cozzi-Lepri, A., Vichi, F., Antinori, A., Bonora, S., D'Arminio Monforte, A., ICONA Foundation Study Group:, A d'Arminio Monforte, Antinori, A, Andreoni, M, Castagna, A, Castelli, F, Cauda, R, G Di Perri, Galli, M, Iardino, R, Ippolito, G, Lazzarin, A, C Marchetti, G, Rezza, G, F von Schloesser, Viale, P, A d'Arminio Monforte, Ceccherini-Silberstein, F, Cozzi-Lepri, A, Girardi, E, S Lo Caputo, Mussini, C, Puoti, M, F Perno, C, Bai, F, Balotta, C, Bandera, A, Bonora, S, Borderi, M, Calcagno, A, Capetti, A, R Capobianchi, M, Cicalini, S, Cingolani, A, Cinque, P, A De Luca, A Di Biagio, Gianotti, N, Gori, A, Guaraldi, G, Lapadula, G, Lichtner, M, Madeddu, G, Maggiolo, F, Marchetti, G, Monno, L, Nozza, S, Pinnetti, C, QUIROS ROLDAN, Maria Eugenia, Rossotti, R, Rusconi, S, M Santoro, M, Saracino, A, Sarmati, L, Fanti, I, Galli, L, Lorenzini, P, Rodano', A, Macchia, M, Tavelli, A, Carletti, F, Carrara, S, A Di Caro, Graziano, S, Petroni, F, Prota, G, Truffa, S, Giacometti, A, Costantini, A, Barocci, V, Angarano, G, Milano, E, Suardi, C, Donati, V, Verucchi, G, Castelnuovo, F, Minardi, C, Menzaghi, B, Abeli, C, Cacopardo, B, Celesia, B, Vecchiet, J, Falasca, K, Pan, A, Lorenzotti, S, Sighinolfi, L, Segala, D, Blanc, P, Vichi, F, Cassola, G, Viscoli, C, Alessandrini, A, Bobbio, N, Mazzarello, G, Vita, S, Bonfanti, P, Molteni, C, Chiodera, A, Milini, P, Nunnari, G, Pellicanò, G, Rizzardini, G, S Cannizzo, E, C Moioli, M, Piolini, R, Bernacchia, D, Salpietro, S, Tincati, C, Puzzolante, C, Migliorino, C, Sangiovanni, V, Borgia, G, Esposito, V, F Di Martino, Gentile, I, Rizzo, V, M Cattelan, A, Marinello, S, Cascio, A, Trizzino, M, Baldelli, F, Schiaroli, E, Parruti, G, Sozio, F, Magnani, G, A Ursitti, M, Cristaudo, A, Vullo, V, Acinapura, R, Moschese, D, Capozzi, M, Mondi, A, M Rivano Capparuccia, Iaiani, G, Latini, A, Gagliardini, R, M Plazzi, M, Savinelli, S, Vergori, A, Cecchetto, M, Viviani, F, A De Vito, Rossetti, B, Montagnani, F, Franco, A, R Fontana Del Vecchio, Francisci, D, C Di Giuli, Caramello, P, C Orofino, G, Sciandra, M, Bassetti, M, Londero, A, Pellizzer, G, Manfrin, V, Starnini, G, Ialungo, A |
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| Přispěvatelé: | Taramasso, L, Lorenzini, P, Di Biagio, A, Lichtner, M, Marchetti, G, Rossotti, R, Lapadula, G, Cozzi-Lepri, A, Vichi, F, Antinori, A, Bonora, S, D'Arminio Monforte, A, d'Arminio Monforte, A, Andreoni, M, Castagna, A, Castelli, F, Cauda, R, Di Perri, G, Galli, M, Iardino, R, Ippolito, G, Lazzarin, A, Marchetti, Gc, Rezza, G, von Schloesser, F, Viale, P, Ceccherini-Silberstein, F, Girardi, E, Lo Caputo, S, Mussini, C, Puoti, M, Perno, Cf, Bai, F, Balotta, C, Bandera, A, Borderi, M, Calcagno, A, Capetti, A, Capobianchi, Mr, Cicalini, S, Cingolani, A, Cinque, P, De Luca, A, Gianotti, N, Gori, A, Guaraldi, G, Madeddu, G, Maggiolo, F, Monno, L, Nozza, S, Pinnetti, C, Quiros Roldan, E, Rusconi, S, Santoro, Mm, Saracino, A, Sarmati, L, Fanti, I, Galli, L, Rodano', A, Macchia, M, Tavelli, A, Carletti, F, Carrara, S, Di Caro, A, Graziano, S, Petroni, F, Prota, G, Truffa, S, Giacometti, A, Costantini, A, Barocci, V, Angarano, G, Milano, E, Suardi, C, Donati, V, Verucchi, G, Castelnuovo, F, Minardi, C, Menzaghi, B, Abeli, C, Cacopardo, B, Celesia, B, Vecchiet, J, Falasca, K, Pan, A, Lorenzotti, S, Sighinolfi, L, Segala, D, Blanc, P, Cassola, G, Viscoli, C, Alessandrini, A, Bobbio, N, Mazzarello, G, Vita, S, Bonfanti, P, Molteni, C, Chiodera, A, Milini, P, Nunnari, G, Pellicanò, G, Rizzardini, G, Cannizzo, E, Moioli, Mc, Piolini, R, Bernacchia, D, Salpietro, S, Tincati, C, Puzzolante, C, Migliorino, C, Sangiovanni, V, Borgia, G, Esposito, V, Di Martino, F, Gentile, I, Rizzo, V, Cattelan, Am, Marinello, S, Cascio, A, Trizzino, M, Baldelli, F, Schiaroli, E, Parruti, G, Sozio, F, Magnani, G, Ursitti, Ma, Cristaudo, A, Vullo, V, Acinapura, R, Moschese, D, Capozzi, M, Mondi, A, Capparuccia, Mr, Iaiani, G, Latini, A, Gagliardini, R, Plazzi, Mm, Savinelli, S, Vergori, A, Cecchetto, M, Viviani, F, De Vito, A, Rossetti, B, Montagnani, F, Franco, A, Fontana Del Vecchio, R, Francisci, D, Di Giuli, C, Caramello, P, Orofino, Gc, Sciandra, M, Bassetti, M, Londero, A, Pellizzer, G, Manfrin, V, Starnini, G, Ialungo, A, Taramasso L., Lorenzini P., Di Biagio A., Lichtner M., Marchetti G., Rossotti R., Lapadula G., Cozzi-Lepri A., Vichi F., Antinori A., Bonora S., Cascio A., D'Arminio Monforte A., Cascio A. in ICONA Foundation Study Group., Taramasso, L., Lorenzini, P., Di Biagio, A., Lichtner, M., Marchetti, G., Rossotti, R., Lapadula, G., Cozzi-Lepri, A., Vichi, F., Antinori, A., Bonora, S., D'Arminio Monforte, A., Castagna, A., A d'Arminio Monforte,i, M Andreoni, A Castagna, F Castelli, R Cauda, G Di Perri, M Galli, R Iardino, G Ippolito, A Lazzarin, G Rezza, F von Schloesser, F Ceccherini-Silberstein, E Girardi, S Lo Caputo, C Mussini, M Puoti, C F Perno, F Bai, C Balotta, A Bandera, M Borderi, A Calcagno, A Capetti, M R Capobianchi, S Cicalini, A Cingolani, P Cinque, A De Luca, E Girardi, N Gianotti, A Gori, G Guaraldi, G Madeddu, F Maggiolo, L Monno, S Nozza, C Pinnetti, E Quiros Roldan, S Rusconi, M M Santoro, A Saracino, L Sarmati, I Fanti, A Rodano', M Macchia, A Tavelli, F Carletti, S Carrara, A Di Caro, S Graziano, F Petroni, G Prota, S Truffa, A Giacometti, A Costantini, V Barocci, G Angarano, L Monno, E Milano, F Maggiolo, C Suardi, P Viale, V Donati, G Verucchi, F Castelnuovo, C Minardi, B Menzaghi, C Abeli, B Cacopardo, B Celesia, J Vecchiet, K Falasca, A Pan, S Lorenzotti, L Sighinolfi, D Segala, P Blanc, G Cassola, C Viscoli, A Alessandrini, N Bobbio, G Mazzarello, S Vita, P Bonfanti, C Molteni, A Chiodera, P Milini, G Nunnari, G Pellicanò, G Rizzardini, E S Cannizzo, M C Moioli, R Piolini, D Bernacchia, S Salpietro, C Tincati, C Puzzolante, C Migliorino, V Sangiovanni, G Borgia, V Esposito, F Di Martino, I Gentile, V Rizzo, A M Cattelan, S Marinello, A Cascio, M Trizzino, F Baldelli, E Schiaroli, G Parruti, F Sozio, G Magnani, M A Ursitti, A Cristaudo, V Vullo, R Acinapura, D Moschese, M Capozzi, A Mondi, M Rivano Capparuccia, G Iaiani, A Latini, R Gagliardini, M M Plazzi, S Savinelli, A Vergori, M Cecchetto, F Viviani, G Madeddu, A De Vito, B Rossetti, F Montagnani, A Franco, R Fontana Del Vecchio, D Francisci, C Di Giuli, P Caramello, G C Orofino, M Sciandra, M Bassetti, A Londero, G Pellizzer, V Manfrin, G Starnini, A Ialungo |
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
Male Integrase inhibitor Hepatitis B Surface Antigen HIV Infections 0302 clinical medicine Risk Factors hivh epatitis c rna surface antigens follow-up homosexuality integrase inhibitors hepatitis b virus hepatitis b virus measurement hiv infections hepatotoxicity hepatitis c virus coinfection nucleoside reverse transcriptase inhibitors non-nucleoside reverse transcriptase inhibitors cox proportional hazards models baseline value liver enzyme raltegravir Pharmacology (medical) HIV Infection 030212 general & internal medicine Prospective Studies Prospective cohort study Coinfection Incidence (epidemiology) Liver Disease Incidence Liver Diseases virus diseases Hepatitis C Middle Aged Reverse Transcriptase Inhibitor Infectious Diseases Cohort Population study Regression Analysis Reverse Transcriptase Inhibitors Female medicine.drug Human Microbiology (medical) Adult medicine.medical_specialty Anti-HIV Agents Regression Analysi NO 03 medical and health sciences Internal medicine medicine Humans HIV Integrase Inhibitors HIV Protease Inhibitor Pharmacology Hepatitis B Surface Antigens business.industry Anti-HIV Agent HIV ART HIV Protease Inhibitors medicine.disease Raltegravir 030112 virology HIV Integrase Inhibitor Prospective Studie HIV-1 business Adult Anti-HIV Agents Coinfection Female Hepatitis B Surface Antigens Hepatitis C HIV Infections HIV Integrase Inhibitors HIV Protease Inhibitors HIV-1 Humans Incidence Liver Diseases Male Middle Aged Prospective Studies Regression Analysis Reverse Transcriptase Inhibitors Risk Factors |
| Popis: | ObjectivesTo evaluate the incidence and risk factors for liver enzyme elevations (LEE) in patients initiating first-line ART in the ICONA prospective observational cohort, between June 2009 and December 2017.Patients and methodsIn total, 6575 ART-naive patients were selected, initiating two NRTIs with the third drug being a boosted PI (n=2436; 37.0%), an NNRTI (n=2384; 36.3%) or an integrase strand transfer inhibitor (INSTI) (n=1755; 26.7%). HBV surface antigen and HCV RNA were detected in 3.9% and 5.8% of the study population. Inverse probability weighted Cox regression analysis was used to calculate the HRs, according to first-line regimen, for LEE, defined as ALT or AST increases of ≥2.5× upper limit of normal (ULN) for patients with normal baseline values or ≥2.5× baseline for patients with higher baseline values.ResultsOne hundred and eighty-three LEE occurred over 20722 patient-years of follow-up. After adjusting for the main confounders, the risk of LEE halved with INSTIs compared with NNRTIs (HR 0.46, 95% CI 0.25–0.86), with a significant reduction in the raltegravir group (HR 0.11, 95% CI 0.02–0.84 using the NNRTI class as reference). HRs for LEE were significantly higher in subjects with HBV or HCV coinfection, in patients with poorly controlled HIV infection and in those who acquired HIV through homosexual transmission.ConclusionsIn our study, INSTI use almost halved the risk of LEE compared with other regimens. This finding could be particularly important for choosing ART in patients with risk factors for liver toxicity such as HCV and HBV coinfections. |
| Databáze: | OpenAIRE |
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