Hepatotoxicity Development During Antiretroviral Therapy Containing Protease Inhibitors in Patients With HIV
| Autor: | Aceti, A, Pasquazzi, C, Zechini, B, De Bac, C, Liverhaart, Group, Cargnel, A, Giorgi, R, Carosi, G, Torti, C, Chiodo, F, Giuliani, R, Concia, Ercole, Cainelli, F, Ghinelli, F, Roda, R, Mazzotta, F, Pierotti, L, Milazzo, F, Fagion, I, Minoli, L, Rizzi, L, Mura, Ms, Sotgiu, G, Ortona, L, Di Gianbenedetto, S, Pastore, G, Cavaliere, R, Piazza, M, Maddaloni, L, Sagnelli, E, Nacca, C, Scalise, G, Del Prete MS, Vullo, V, Santopadre, P. |
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| Rok vydání: | 2002 |
| Předmět: |
Adult
Male hepatotoxicity Time Factors Hepatitis C virus protease inhibitors HIV Infections medicine.disease_cause Antiviral Agents Risk Factors Prevalence medicine Humans Pharmacology (medical) Protease inhibitor (pharmacology) Retrospective Studies Hepatitis Ritonavir business.industry HIV Alanine Transaminase Bilirubin HIV Protease Inhibitors Viral Load Hepatitis B medicine.disease Hepatitis C ART hepatotoxicity hepatitis C or B virus HIV protease inhibitors Infectious Diseases Italy Chemical and Drug Induced Liver Injury Chronic Immunology Coinfection Regression Analysis Female hepatitis C or B virus business Viral hepatitis Viral load ART medicine.drug |
| Zdroj: | Scopus-Elsevier |
| ISSN: | 1525-4135 |
| DOI: | 10.1097/00042560-200201010-00005 |
| Popis: | To evaluate the occurrence of hepatotoxicity in patients during antiretroviral therapy (ART) that contains protease inhibitors and the role of hepatitis viruses in its development, we performed a retrospective study including 1325 HIV-infected patients treated with ART for at least 6 months. Presence or absence of hepatitis viruses, alanine aminotransferase (ALT), total bilirubin, CD4 cell count, and plasma HIV RNA levels were evaluated. Hepatotoxicity developed in a few study subjects without coinfection, whereas it was significantly higher in coinfected patients. Univariate logistic regression analysis showed that viral hepatitis coinfections are independent risk factors for hepatotoxicity. After 6 months of treatment, ritonavir was associated with higher rates of severe hepatotoxicity in the coinfected group; in fact, ritonavir seems to be the most strongly hepatotoxic agent among coinfected patients. After 12 months of therapy, hepatotoxicity occurred more frequently in patients with hepatitis C virus who did not respond to antiretroviral therapy (ART), whereas patients who did respond to ART showed decreased ALT levels. Hepatotoxicity is not exclusively an effect of drug toxicity, and the presence of hepatitis coinfection is an independent risk factor. Moreover, chronic hepatotoxicity mainly occurs in patients who did not respond to therapy. Conversely, patients who did respond to ART seemed to show improvement of chronic liver infection. |
| Databáze: | OpenAIRE |
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