Hepatotoxicity associated with antiretroviral therapy containing dual versus single protease inhibitors in individuals coinfected with hepatitis C virus and human immunodeficiency virus.
To determine the rates of patients coinfected with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) who discontinued therapy as a result of protease inhibitor (PI)-related hepatotoxicity, a retrospective review was conducted. Baseline CD4 counts, plasma HIV RNA levels, and duration of therapy were comparable between single- and dual-PI-treated subjects and between subjects receiving ritonavir-containing therapy and those receiving ritonavir-sparing therapy. The proportions of patients with elevations in alanine aminotransferase level to > or =5 times the upper limit of normal (19% versus 26%) and hyperbilirubinemia (30% versus 38%) were similar between the dual-PI (n=27) and single-PI treatment groups (n=39), respectively. No difference in these characteristics was observed between ritonavir-containing (n=34) and ritonavir-sparing (n=32) treatment arms. Rates of treatment discontinuation due to hepatotoxicity were similar for single-PI and dual-PI therapy and for ritonavir-containing and ritonavir-sparing regimens. Dual-PI therapy and inclusion of ritonavir do not seem to increase the rates of hepatotoxicity in PI-treated, HIV-HCV coinfected subjects.
Cooper
Curtis L
CL
Division of Infectious Diseases, Ottawa Hospital Research Institute, University of Ottawa, Ontario, Canada, K1H 8L6. Ccooper@ottawahospital.on.ca
Parbhakar
M A
MA
Angel
Jonathan B
JB
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D005260:Female; D006678:HIV / Q000187:drug effects; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D017320:HIV Protease Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D016174:Hepacivirus / Q000187:drug effects; D006526:Hepatitis C / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D008107:Liver Diseases / Q000209:etiology*; D008297:Male
D017320:HIV Protease Inhibitors