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Title: Changes in Liver Steatosis After Switching From Efavirenz to Raltegravir Among Human Immunodeficiency Virus-Infected Patients With Nonalcoholic Fatty Liver Disease.
Authors: Macías, Juan
Mancebo, María
Merino, Dolores
Téllez, Francisco
Montes-Ramírez, M Luisa
Pulido, Federico
Rivero-Juárez, Antonio
Raffo, Miguel
Pérez-Pérez, Montserrat
Merchante, Nicolás
Cotarelo, Manuel
Pineda, Juan A
Spanish AIDS Research Network-HEP09 Study Group
Keywords: HIV;efavirenz;nonalcoholic fatty liver disease;raltegravir
metadata.dc.subject.mesh: Alkynes
Anti-HIV Agents
Body Mass Index
Body Weight
Drug Substitution
Drug Therapy, Combination
Elasticity Imaging Techniques
HIV Infections
Middle Aged
Non-alcoholic Fatty Liver Disease
Raltegravir Potassium
Waist-Hip Ratio
Issue Date: 2017
Abstract: Antiretroviral drugs with a lower potential to induce hepatic steatosis in human immunodeficiency virus (HIV) infection need to be identified. We compared the effect of switching efavirenz (EFV) to raltegravir (RAL) on hepatic steatosis among HIV-infected patients with nonalcoholic fatty liver disease (NAFLD) receiving EFV plus 2 nucleoside analogues. HIV-infected patients on EFV plus tenofovir/emtricitabine or abacavir/lamivudine with NAFLD were randomized 1:1 to switch from EFV to RAL (400 mg twice daily), maintaining nucleoside analogues unchanged, or to continue with EFV plus 2 nucleoside analogues. At baseline, eligible patients should show controlled attenuation parameter (CAP) values ≥238 dB/m. Changes in hepatic steatosis at 48 weeks of follow-up over baseline levels were measured by CAP. Overall, 39 patients were included, and 19 of them were randomized to switch to RAL. At week 48, median CAP for the RAL group was 250 (Q1-Q3, 221-277) dB/m and 286 (Q1-Q3, 269-314) dB/m for the EFV group (P = .035). The median decrease in CAP values was -20 (Q1-Q3, -67 to 15) dB/m for the RAL arm and 30 (Q1-Q3, -17 to 49) dB/m for the EFV group (P = .011). CAP values After 48 weeks, HIV-infected individuals switching EFV to RAL showed decreases in the degree of hepatic steatosis, as measured by CAP, compared with those continuing with EFV. In addition, the proportion of patients without significant hepatic steatosis after 48 weeks was greater for those who switched to RAL. NCT01900015.
metadata.dc.identifier.doi: 10.1093/cid/cix467
Appears in Collections:Producción 2020

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