Hepatitis B or hepatitis C virus infection is a risk factor for severe hepatic cytolysis after initiation of a protease inhibitor-containing antiretroviral regimen in human immunodeficiency virus-infected patients. The APROCO Study Group.
In a cohort of 1,047 human immunodeficiency virus type 1-infected patients started on protease inhibitors (PIs), the incidence of severe hepatic cytolysis (alanine aminotransferase concentration five times or more above the upper limit of the normal level >/= 5N) was 5% patient-years after a mean follow-up of 5 months. Only positivity for hepatitis C virus antibodies (hazard ratio [HR], 7. 95; P < 10(-3)) or hepatitis B virus surface antigen (HR, 6.67; P < 10(-3)) was associated with severe cytolysis. Before starting patients on PIs, assessment of liver enzyme levels and viral coinfections is necessary.
Savès
M
M
INSERM Unité 330, 33076 Bordeaux Cedex, France.
Raffi
F
F
Clevenbergh
P
P
Marchou
B
B
Waldner-Combernoux
A
A
Morlat
P
P
Le Moing
V
V
Rivière
C
C
Chêne
G
G
Leport
C
C
D017088:AIDS-Related Opportunistic Infections / Q000276:immunology / Q000473:pathology*; D000328:Adult; D000410:Alanine Transaminase / Q000378:metabolism; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D017320:HIV Protease Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D015497:HIV-1 / Q000276:immunology; D016174:Hepacivirus / Q000276:immunology; D006509:Hepatitis B / Q000209:etiology / Q000276:immunology / Q000473:pathology* / Q000821:virology; D006515:Hepatitis B virus / Q000276:immunology; D006526:Hepatitis C / Q000209:etiology / Q000276:immunology / Q000473:pathology* / Q000821:virology; D022781:Hepatocytes / Q000187:drug effects / Q000473:pathology* / Q000821:virology; D006801:Humans; D008099:Liver / Q000473:pathology*; D008297:Male; D012307:Risk Factors
D017320:HIV Protease Inhibitors; D000410:Alanine Transaminase