%0 Journal Article
%A Neukam, Karin
%A Mira, José A
%A Collado, Antonio
%A Rivero-Juárez, Antonio
%A Monje-Agudo, Patricia
%A Ruiz-Morales, Josefa
%A Ríos, María José
%A Merino, Dolores
%A Téllez, Francisco
%A Pérez-Camacho, Inés
%A Gálvez-Contreras, María Carmen
%A Rivero, Antonio
%A Pineda, Juan A
%T Liver Toxicity of Current Antiretroviral Regimens in HIV-Infected Patients with Chronic Viral Hepatitis in a Real-Life Setting: The HEPAVIR SEG-HEP Cohort.
%D 2016
%U http://hdl.handle.net/10668/2221
%X OBJECTIVETo assess the current frequency of ART-associated grade 3-4 transaminase elevations (TE) and grade 4 total bilirubin elevations (TBE) in HIV-infected patients with chronic hepatitis B and/or C, who start a new regimen of ART.PATIENTS AND METHODSA total of 192 pre-treated or treatment-naive HIV infected patients with HBV and/or HCV-coinfection who started ART in eight Southern Spanish centers from July/2011-December/2013, were followed for 12 months in this prospective study.RESULTSForty-one (21.4%) subjects had been naïve to ART, median (IQR) follow-up was 11.6 (5.6-12.9) months. The most frequently initiated NRTI were tenofovir/emtricitabine [49 patients (25.5%)]. Eighty-nine (46.4%) patients started a ritonavir-boosted protease inhibitor and 77 (40.1%) individuals a NNRTI. Raltegravir and maraviroc were initiated in 24 (12.5%) and 9 (4.7%) individuals. Ten [5.21%; 95% confidence interval (CI): 2.53%-9.37%] patients presented grade 3 TE, while 8 (4.17%; 95%CI: 1.82%-8.04%) subjects showed grade 4 TBE. No episodes of grade 4 TE or ART discontinuation due to hepatotoxic events were observed. The use of ritonavir-boosted atazanavir was the only independent predictor for grade 4 TBE [adjusted odds ratio: 7.327 (95%CI: 1.417-37.89); p = 0.018] in an analysis adjusted for age, sex and baseline HIV-RNA levels, while no factor could be independently associated with grade 3-4 TE.CONCLUSIONSCurrently, the frequency of severe ART-associated TE and TBE under real-life conditions in patients with chronic viral hepatitis is similar to what has been reported previously. However, episodes of grade 4 TE are less frequent and severe TE appears to be of lesser concern.
%K Hepatitis B crónica
%K Bilirrubina
%K Ciclohexanos
%K Estudios de seguimiento
%K Infecciones por VIH
%K Inhibidores de proteasas
%K ARN
%K Inhibidores de la transcriptasa inversa
%K Transaminasas
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