Longitudinal effect of antiretroviral therapy on markers of hepatic toxicity: impact of hepatitis C coinfection.
To characterize longitudinal hepatic toxicity of antiretroviral therapy in HIV-infected women with and without hepatitis C virus (HCV) infection, we measured alanine and aspartate aminotransferase values among women initiating highly active antiretroviral therapy (HAART). For 312 HIV/HCV coinfected women who received HAART for a mean of 1.8 years, the prevalence of elevated aminotransferase levels >3 times and >5 times the upper limit of normal (ULN) was low (<12% and <4%, respectively), and the prevalence of elevated aminotransferase levels declined over time. When we analyzed trends in aminotransferase levels according to type of HAART received among HCV-infected and uninfected women, we found that mean aminotransferase levels declined among 539 women receiving therapy with protease inhibitors (decreases of 5.34%-4.23% of the ULN per year; P values for trend of.007-.06), but mean values among 128 women receiving therapy with nonnucleoside reverse-transcriptase inhibitors remained stable (from decreases of 1.65% to increases of 7.57% of the ULN per year; P values of.19-.71). Our findings lend support to assertions that antiretroviral therapy is safe for women with HCV infection.
CORE Center/Cook County Hospital, Rush Medical College, Chicago, IL 60612, USA. Audrey_French@rush.edu
Audrey L
AL
French
Lorie
L
Benning
Kathryn
K
Anastos
Michael
M
Augenbraun
Marek
M
Nowicki
Kunthavi
K
Sathasivam
Norah A
NA
Terrault
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood*; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D001219:Aspartate Aminotransferases / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D056486:Chemical and Drug Induced Liver Injury; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy* / Q000201:enzymology; D017320:HIV Protease Inhibitors / Q000008:administration & dosage / Q000009:adverse effects; D006526:Hepatitis C / Q000150:complications* / Q000201:enzymology; D006801:Humans; D008107:Liver Diseases / Q000175:diagnosis; D008137:Longitudinal Studies; D008875:Middle Aged; D018894:Reverse Transcriptase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects
D015415:Biomarkers; D017320:HIV Protease Inhibitors; D018894:Reverse Transcriptase Inhibitors; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase