Retrospective evaluation of the effect of valproate therapy on transaminase elevations in patients with hepatitis C.
OBJECTIVE
To evaluate whether a relationship exists between valproate treatment and transaminase elevations in patients who are positive for hepatitis C virus (HCV).


METHODS
Retrospective medical record review.


METHODS
Veterans affairs medical center.


METHODS
A total of 214 HCV-positive patients; 28 were treated with valproate (study group), 186 were not (control group).


METHODS
Demographic characteristics; valproate treatment histories; plasma concentrations of alanine aminotransferase (ALT) and aspartate aminotransferase (AST), albumin, and bilirubin; and exposure to other potentially hepatotoxic drugs, including probable alcohol abuse, were evaluated.


RESULTS
Hepatotoxicity was staged by comparing maximum ALT and AST values against upper limits of normal or patients' mean elevated baseline ALT and AST values. Data were analyzed using a logistic regression model. Control patients and those with longer durations of HCV were more likely (p<0.0171 and p<0.0142, respectively) to exhibit higher stages of hepatotoxicity. More valproate-treated patients were exposed to other potential hepatotoxins at the time of peak transaminase elevations (50% vs 39%, p<0.005), whereas more control patients received two or more potential hepatotoxins (13% vs 4%, p<0.00005).


CONCLUSIONS
Valproate treatment, either alone or in the presence of other potential hepatotoxins, does not appear to be related to increased transaminase elevations in patients with HCV
Lott
R S
RS
Boise Veterans Affairs Medical Center, and the Department of Pharmacy Practice and Administrative Sciences, College of Pharmacy, Idaho State University, 83702, USA.
Helmboldt
K M
KM
Madaras-Kelly
K J
KJ
D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D056486:Chemical and Drug Induced Liver Injury; D016009:Chi-Square Distribution; D004341:Drug Evaluation / Q000706:statistics & numerical data*; D004791:Enzyme Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006526:Hepatitis C / Q000150:complications / Q000201:enzymology*; D006801:Humans; D008107:Liver Diseases / Q000150:complications / Q000201:enzymology; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy / Q000201:enzymology; D008875:Middle Aged; D010361:Patients / Q000706:statistics & numerical data; D012189:Retrospective Studies; D000637:Transaminases / Q000097:blood*; D014635:Valproic Acid / Q000009:adverse effects / Q000627:therapeutic use*
D004791:Enzyme Inhibitors; D014635:Valproic Acid; D000637:Transaminases; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase