{"id":4832,"date":"2001-10-01T20:42:32","date_gmt":"2001-10-01T19:42:32","guid":{"rendered":"http:\/\/moomango.co.uk\/htb\/?p=4832"},"modified":"2014-06-11T14:19:43","modified_gmt":"2014-06-11T14:19:43","slug":"severe-hepatic-injury-common-after-haart-initiation","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/4832","title":{"rendered":"Severe hepatic injury common after HAART initiation"},"content":{"rendered":"

Severe transaminase elevations commonly follow the initiation of highly active antiretroviral therapy (HAART), particularly in individuals co-infected with hepatitis C virus, according to a report in the August 15th issue of the Journal of Acquired Deficiency Syndromes.<\/strong><\/p>\n

Previous studies have suggested that liver toxicity may limit the use of HAART in 2% to 18% of patients, the authors explain, but the overall incidence of and the risk factors contributing to severe hepatic injury with HAART are not well known.<\/p>\n

Dr. Vincent Soriano and colleagues from Hospital Carlos III in Madrid, Spain sought to clarify these issues by reviewing the records of 222 HIV-infected subjects who initiated HAART at their hospital between January 1997 and January 2000.<\/p>\n

Thirty-eight percent of the patients were co-infected with hepatitis C, 5% with hepatitis B, and 2% with hepatitis D, the report indicates.<\/p>\n

Nearly one third of the patients (68 subjects) showed some transaminase elevation after initiation of HAART, the authors report, with the highest values being recorded after a median 6 months on therapy.<\/p>\n

Independent risk factors for transaminase elevation included hepatitis C co-infection (p = 0.0001), alcohol abuse (p = 0.04), intravenous drug use (p = 0.001), and didanosine therapy (p = 0.002), the results indicate.<\/p>\n

Severe transaminase elevation occurred in 21 patients (9%) and required HAART discontinuation in 6 individuals, the researchers note, without significant differences in incidence among the antiretroviral drug classes.<\/p>\n

In multivariate analysis, the risk of severe transaminase elevation was significantly higher with hepatitis C co-infection, high alcohol intake, and older age, the report indicates.<\/p>\n

All patients whose transaminase elevations persisted were anti-hepatitis C positive, the investigators say.<\/p>\n

“Ten percent of HIV-positive patients who began HAART experienced high transaminase elevations, ” Dr. Soriano told Reuters Health. “This complication is more common among those with pre-existing chronic hepatitis C.”<\/p>\n

“Treatment of chronic hepatitis C among HIV-coinfected persons should be encouraged to prevent long-term complications of hepatitis C (cirrhosis) and favour a better tolerance of antiretrovirals, ” Dr. Soriano concluded.<\/p>\n

Reference:<\/p>\n

Nunez M et al. Risk factors for severe hepatic injury after introduction of highly active antiretroviral therapy. J Acquired Defic Synd 2001; 27:426-431.
\nhttp:\/\/www.ncbi.nlm.nih.gov\/pubmed\/11511818?dopt=Abstract<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

Severe transaminase elevations commonly follow the initiation of highly active antiretroviral therapy (HAART), particularly in individuals co-infected with hepatitis C virus, according to a report in the August 15th issue of the Journal of Acquired Deficiency Syndromes. Previous studies have …<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[8,24],"tags":[],"class_list":["post-4832","post","type-post","status-publish","format-standard","hentry","category-side-effects","category-hepatitis-coinfection"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/4832","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=4832"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/4832\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=4832"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=4832"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=4832"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}