Safety, efficacy, and tolerability of nelfinavir-containing antiretroviral therapy for patients coinfected with HIV and hepatitis C undergoing methadone maintenance

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jsat.2006.03.006 Byline: Lawrence S. Brown (a)(b), Steven Kritz (a), Melissa Chu (a), Charles Madray (a) Keywords: HIV; Hepatitis C; Nelfinavir; Methadone maintenance Abstract: The safety, efficacy, and tolerability of nelfinavir (NFV)-containing antiretroviral therapy were evaluated in patients coinfected with HIV and hepatitis C undergoing methadone maintenance at an urban outpatient opioid treatment program serving a minority adult population. Eligibility covered methadone-maintained patients coinfected with HIV and hepatitis C who had received or were currently receiving NFV. The yield was 51 case patients. Parameters examined looked into safety, efficacy, and tolerability. Nelfinavir was discontinued in 2 patients for liver function abnormalities but resumed in 1 patient. One patient developed laboratory abnormalities during NFV therapy that were not present before NFV therapy; in 12 case patients, pre-NFV therapy liver function abnormalities resolved completely during NFV therapy. There was a statistically significant increase in CD4 count during NFV therapy. Viral load decreased or was unchanged in 10 case patients and increased in 8, of whom 5 had a CD4 count increase during NFV therapy. Three patients had diarrhea and 4 patients had constipation. Nelfinavir was not discontinued -- neither was dose adjusted -- in any of these patients. Patients who had received NFV [greater than or equal to]36 months had a smaller increase in mean methadone dose as compared with patients who had received NFV Author Affiliation: (a) Division of Medical Services, Evaluation and Research, Addiction Research and Treatment Corporation, Brooklyn, NY 11201, USA (b) Department of Public Health, Weill Medical College, Cornell University, New York, NY 10021, USA Article History: Received 17 January 2006; Accepted 13 March 2006