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Titolo:
Risk factors for severe hepatic injury after introduction of highly activeantiretroviral therapy
Autore:
Nunez, M; Lana, R; Mendoza, JL; Martin-Carbonero, L; Soriano, V;
Indirizzi:
Hosp Carlos III, Inst Salud Carlos III, Infect Dis Serv, Madrid, Spain Hosp Carlos III Madrid Spain Carlos III, Infect Dis Serv, Madrid, Spain
Titolo Testata:
JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES
fascicolo: 5, volume: 27, anno: 2001,
pagine: 426 - 431
SICI:
1525-4135(20010815)27:5<426:RFFSHI>2.0.ZU;2-H
Fonte:
ISI
Lingua:
ENG
Soggetto:
HIV-INFECTED PATIENTS; PROTEASE INHIBITORS; COMBINATION THERAPY; B VIRUS; HEPATOTOXICITY; RIBAVIRIN; STEATOSIS;
Keywords:
HIV; antiretroviral therapy; HAART; liver toxicity; hepatitis C virus;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
27
Recensione:
Indirizzi per estratti:
Indirizzo: Soriano, V C Sinesio Delgado 10, E-28029 Madrid, Spain C Sinesio Delgado 10 Madrid Spain E-28029 28029 Madrid, Spain
Citazione:
M. Nunez et al., "Risk factors for severe hepatic injury after introduction of highly activeantiretroviral therapy", J ACQ IMM D, 27(5), 2001, pp. 426-431

Abstract

Objectives: Treatment of HIV infection with highly antiretroviral therapy (HAART) may be limited by liver toxicity. Its incidence and risk factors are not well known. Patients and Methods: Retrospective chart review. Naive patients beginningHAART between January 1997 and January 2000. Severe transaminase elevationwas defined as fivefold or higher rise over upper normal limits, or as greater than or equal to3.5-fold rise above abnormal baseline values. Results: Of 222 study subjects, 38%, 5%, and 2% were coinfected with hepatitis C virus (HCV), hepatitis B virus, and hepatitis D virus, respectively. Besides two nucleoside reverse transcriptase inhibitors (NRTIs), 96 patients received protease inhibitors (Pls), 90 received nonnucleoside reverse transcriptase inhibitors (NNRTIs), and 35 received a PI + NNRTI combination. Severe hepatic injury developed in 21 (9%): 10% PI, 9%, and 9% PI + NNRTI. Both univariate and multivariate analyses identified alcohol abuse, HCV coinfection, and older age as independent risk factors. Predictor variables inthe final multivariate model were alcohol abuse (risk ratio [RR], 5.87 95%, confidence interval [CI], 1.49-23.15; p = .01), positive HCV serology (RR, 3.99 95% CI, 1.32-12.10; p = .01), and older age (RR, 1.11; 95% CI, 1.04-1.18; p = 0.001). Conclusions: Nearly 10% of study subjects who start HAART experience severe transaminase elevation, irrespective of the treatment. Avoidance of alcohol abuse, especially in study subjects coinfected with HCV, will reduce therisk of hepatic injury after HAART. When possible, prior treatment for chronic HCV infection should be considered.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 18/01/20 alle ore 01:50:08