title: Antiretroviral drug-related liver mortality among HIV-positive persons in the absence of hepatitis B or C virus coinfection: the data collection on adverse events of anti-HIV drugs study.
abstract: BACKGROUND
  Liver diseases are the leading causes of death in human immunodeficiency virus (HIV)-positive persons since the widespread use of combination antiretroviral treatment (cART). Most of these deaths are due to hepatitis C (HCV) or B (HBV) virus coinfections. Little is known about other causes. Prolonged exposure to some antiretroviral drugs might increase hepatic mortality.
  
  
  METHODS
  All patients in the Data Collection on Adverse Events of Anti-HIV Drugs study without HCV or HBV coinfection were prospectively followed from date of entry until death or last follow-up. In patients with liver-related death, clinical charts were reviewed using a structured questionnaire.
  
  
  RESULTS
  We followed 22 910 participants without hepatitis virus coinfection for 114 478 person-years. There were 12 liver-related deaths (incidence, 0.10/1000 person-years); 7 due to severe alcohol use and 5 due to established ART-related toxicity. The rate of ART-related deaths in treatment-experienced persons was 0.04/1000 person-years (95% confidence interval, .01, .10).
  
  
  CONCLUSIONS
  We found a low incidence of liver-related deaths in HIV-infected persons without HCV or HBV coinfection. Liver-related mortality because of ART-related toxicity was rare.
authors.affiliation: Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Switzerland. helen.kovari@usz.ch
authors.forename: Helen
authors.initials: H
authors.lastname: Kovari
authors.forename: Caroline A
authors.initials: CA
authors.lastname: Sabin
authors.forename: Bruno
authors.initials: B
authors.lastname: Ledergerber
authors.forename: Lene
authors.initials: L
authors.lastname: Ryom
authors.forename: Signe W
authors.initials: SW
authors.lastname: Worm
authors.forename: Colette
authors.initials: C
authors.lastname: Smith
authors.forename: Andrew
authors.initials: A
authors.lastname: Phillips
authors.forename: Peter
authors.initials: P
authors.lastname: Reiss
authors.forename: Eric
authors.initials: E
authors.lastname: Fontas
authors.forename: Kathy
authors.initials: K
authors.lastname: Petoumenos
authors.forename: Stéphane
authors.initials: S
authors.lastname: De Wit
authors.forename: Philippe
authors.initials: P
authors.lastname: Morlat
authors.forename: Jens D
authors.initials: JD
authors.lastname: Lundgren
authors.forename: Rainer
authors.initials: R
authors.lastname: Weber
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000009:adverse effects* / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects* / Q000379:methods; D003625:Data Collection; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology* / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D015994:Incidence; D017093:Liver Failure / Q000139:chemically induced* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016019:Survival Analysis
chemical_list: D044966:Anti-Retroviral Agents