TY - JOUR
T1 - Hepatitis B and C virus co-infection and the risk for hepatotoxicity of highly active antiretroviral therapy in HIV-1 infection
AU - Den Brinker, Marieke
AU - Wit, Ferdinand W.N.M.
AU - Wertheim-van Dillen, Pauline M.E.
AU - Jurriaans, Suzanne
AU - Weel, Jan
AU - Van Leeuwen, Remko
AU - Pakker, Nadine G.
AU - Reiss, Peter
AU - Danner, Sven A.
AU - Jan Weverling, Gerrit
AU - Lange, Joep M.A.
PY - 2000
Y1 - 2000
N2 - Objective: To investigate the risk of hepatotoxicity after initiation of prolease inhibitor-containing highly active antiretroviral therapy (HAART) for HIV-1 infected patients with chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) co-infection. Design: Retrospective study with 394 HIV-1-infected patients initiating HAART at a single university clinic. Methods: Liver enzyme elevation (LEE) was defined as alanine aminotransferase or aspartate aminotransferase at least five times the upper limit of normal and an absolute increase of > 100 U/l. Relative risks for time to LEE were estimated using Cox proportional hazards models. Results: Of 394 patients 7% were hepatitis B surface antigen (HBsAg)-positive and 14% were anti-HCV-positive. Patients with chronic hepatitis had a higher risk for LEE compared with patients without co-infection: 37% versus 12% respectively. After adjustment for higher baseline transaminases, the presence of HBsAg or anti-HCV remained associated with an increased risk of LEE - relative risk 2.78 (95% confidence interval, 1.50-5.16) and 2.46 (95% confidence interval, 1.43-4.24) respectively. In patients with LEE, transaminases declined whether HAART was continued or modified. Of patients with chronic HBV infection 38% lost HBeAg or developed anti-HBe after initiation of HAART, and one seroconverted from HBsAg-positive to anti-HBs-positive. However, there was no clear relationship with LEE. Conclusions: HIV-1-infected patients co-infected wilh HBV or HCV were at considerably higher risk of developing LEE when HAART was initiated compared with patients withoul co-infection, but it is usually not necessary to modify antiretroviral therapy.
AB - Objective: To investigate the risk of hepatotoxicity after initiation of prolease inhibitor-containing highly active antiretroviral therapy (HAART) for HIV-1 infected patients with chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) co-infection. Design: Retrospective study with 394 HIV-1-infected patients initiating HAART at a single university clinic. Methods: Liver enzyme elevation (LEE) was defined as alanine aminotransferase or aspartate aminotransferase at least five times the upper limit of normal and an absolute increase of > 100 U/l. Relative risks for time to LEE were estimated using Cox proportional hazards models. Results: Of 394 patients 7% were hepatitis B surface antigen (HBsAg)-positive and 14% were anti-HCV-positive. Patients with chronic hepatitis had a higher risk for LEE compared with patients without co-infection: 37% versus 12% respectively. After adjustment for higher baseline transaminases, the presence of HBsAg or anti-HCV remained associated with an increased risk of LEE - relative risk 2.78 (95% confidence interval, 1.50-5.16) and 2.46 (95% confidence interval, 1.43-4.24) respectively. In patients with LEE, transaminases declined whether HAART was continued or modified. Of patients with chronic HBV infection 38% lost HBeAg or developed anti-HBe after initiation of HAART, and one seroconverted from HBsAg-positive to anti-HBs-positive. However, there was no clear relationship with LEE. Conclusions: HIV-1-infected patients co-infected wilh HBV or HCV were at considerably higher risk of developing LEE when HAART was initiated compared with patients withoul co-infection, but it is usually not necessary to modify antiretroviral therapy.
KW - HIV-1
KW - Hepatitis B virus
KW - Hepatitis C virus
KW - Hepatotoxicity
KW - Highly active antiretroviral therapy
KW - Liver enzyme elevation
UR - http://www.scopus.com/inward/record.url?scp=0034523342&partnerID=8YFLogxK
U2 - https://doi.org/10.1097/00002030-200012220-00011
DO - https://doi.org/10.1097/00002030-200012220-00011
M3 - Article
C2 - 11153671
SN - 0269-9370
VL - 14
SP - 2895
EP - 2902
JO - AIDS
JF - AIDS
IS - 18
ER -