1. Highly active antiretroviral therapy-related hepatotoxicity in human immunodeficiency virus and hepatitis C virus co-infected patients with advanced liver fibrosis in Taiwan.
- Author
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Chou CC, Tsai HC, Wu KS, Sy CL, Chen JK, Chen YS, and Lee SS
- Subjects
- Adult, Cohort Studies, Coinfection virology, Female, HIV Infections virology, HIV-1 drug effects, Hepacivirus drug effects, Hepatitis C, Chronic virology, Humans, Liver drug effects, Male, Middle Aged, Retrospective Studies, Taiwan, Transaminases blood, Anti-HIV Agents adverse effects, Anti-HIV Agents therapeutic use, Antiretroviral Therapy, Highly Active adverse effects, HIV Infections drug therapy, Hepatitis C, Chronic drug therapy, Liver pathology, Liver Cirrhosis pathology
- Abstract
Background: The prevalence of patients co-infected with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) is higher in Taiwan than in Western countries. This study aimed to analyze the frequency and risk factors for highly active antiretroviral therapy (HAART)-related liver toxicity in patients co-infected with HIV and HCV with advanced liver fibrosis in Taiwan., Methods: This retrospective cohort study included 228 HAART-experienced and HAART-naïve patients who were co-infected with HIV and HCV from January 2013 to December 2013 in Taiwan. Transaminase elevation (TE) was defined by grades. Fibrosis 4 score and aspartate-to-platelet ratio index were used to evaluate liver fibrosis. Cox proportional hazard regression model was used to analyze the risk factors for time to TE events., Results: A total of 228 patients were included. Only two episodes (1.28%) of high-grade TE were observed. The overall prevalence rate of TE was 16%, and the incidence was 1.38 cases/100 patient-months. Two predictive factors of TE were the initiation of HAART during the study period and CD4 cell count less than 350 cells/mm(3). Subgroup analysis showed that HAART improved liver fibrosis status in patients who had advanced liver fibrosis at baseline (p = 0.033)., Conclusion: The frequency of HAART-related TE in HIV and HCV co-infected patients in Taiwan was much lower than that observed in previous studies. Pre-existing advanced liver fibrosis had no influence on the frequency of TE. The use of HAART showed benefits on liver fibrosis progression in patients with underlying advanced liver fibrosis., (Copyright © 2014. Published by Elsevier B.V.)
- Published
- 2016
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