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Title: Liver Toxicity of Current Antiretroviral Regimens in HIV-Infected Patients with Chronic Viral Hepatitis in a Real-Life Setting: The HEPAVIR SEG-HEP Cohort.
Authors: Neukam, Karin
Mira, José A
Collado, Antonio
Rivero-Juárez, Antonio
Monje-Agudo, Patricia
Ruiz-Morales, Josefa
Ríos, María José
Merino, Dolores
Téllez, Francisco
Pérez-Camacho, Inés
Gálvez-Contreras, María Carmen
Rivero, Antonio
Pineda, Juan A
HEPAVIR SEG-HEP-2007 Study Group of the Sociedad Andaluza de Enfermedades Infecciosas (SAEI)
metadata.dc.subject.mesh: Adult
Anti-HIV Agents
Cohort Studies
Follow-Up Studies
HIV Infections
Hepatitis B, Chronic
Hepatitis C, Chronic
Middle Aged
Issue Date: 5-Feb-2016
Abstract: To assess the current frequency of ART-associated grade 3-4 transaminase elevations (TE) and grade 4 total bilirubin elevations (TBE) in HIV-infected patients with chronic hepatitis B and/or C, who start a new regimen of ART. A total of 192 pre-treated or treatment-naive HIV infected patients with HBV and/or HCV-coinfection who started ART in eight Southern Spanish centers from July/2011-December/2013, were followed for 12 months in this prospective study. Forty-one (21.4%) subjects had been naïve to ART, median (IQR) follow-up was 11.6 (5.6-12.9) months. The most frequently initiated NRTI were tenofovir/emtricitabine [49 patients (25.5%)]. Eighty-nine (46.4%) patients started a ritonavir-boosted protease inhibitor and 77 (40.1%) individuals a NNRTI. Raltegravir and maraviroc were initiated in 24 (12.5%) and 9 (4.7%) individuals. Ten [5.21%; 95% confidence interval (CI): 2.53%-9.37%] patients presented grade 3 TE, while 8 (4.17%; 95%CI: 1.82%-8.04%) subjects showed grade 4 TBE. No episodes of grade 4 TE or ART discontinuation due to hepatotoxic events were observed. The use of ritonavir-boosted atazanavir was the only independent predictor for grade 4 TBE [adjusted odds ratio: 7.327 (95%CI: 1.417-37.89); p = 0.018] in an analysis adjusted for age, sex and baseline HIV-RNA levels, while no factor could be independently associated with grade 3-4 TE. Currently, the frequency of severe ART-associated TE and TBE under real-life conditions in patients with chronic viral hepatitis is similar to what has been reported previously. However, episodes of grade 4 TE are less frequent and severe TE appears to be of lesser concern.
metadata.dc.identifier.doi: 10.1371/journal.pone.0148104
Appears in Collections:Producción 2020

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