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Abstract
Nucleoside analogue transcriptase inhibitors and liver toxicity among patients treated for HIV disease
Calza L.1, Manfredi R.1, Verucchi G.1, Chiodo F.1
Introduction: liver toxicity is frequent among HIV+ patients (p) taking antiretroviralS (6-30% of cases,according to different evidences).Underlying chronic hepatitis,alcoholism,and use of drugs (including HIV-related ones),are significant risk factors for toxic liver events.Aim of our study is to assess the frequency and risk factors for hepatotoxicity in a cohort of HIV+ p treated with at least 2 nucleoside analogues (NA).
Methods: A retrospective-prospective study on p treated with >2 NA since >24 months was conducted,and data were evaluated according to relevant clinical-laboratory variables.
Results: Of 1004 HIV+ treated p,147 (14.6%) received dual NA therapy,and were enrolled in our study.These 147 p were compared according to the specific taken combinations:group A (3TC-d4T,73 p),group B (ZDV-3TC,60 p), group C (ddI-d4T,28 p),and group D (ZDV-ddI,12 p).The overall prevalence of chronic HCV and HBV hepatitis was 44.2% and 4.8%,respectively,in absence of differences among the 4 p groups.An increase of ALT levels (>40 U/L) was found in 76 p (51.7%),with greater prevalence in group A versus group C,group B,and group D.The frequency of hepatic toxicity tested significantly higher in p of groups A and C,versus groups B and D (p<.05).However, a grade 3-4 liver toxicity was detected in only 9 p (6.1%),7 of group A and 2 of group C.The occurrence of hepatic toxicity was not related to a broad variety of epidemiologic,virologic,and immunologic variables,but proved significantly more frequent among HCV-coinfected p versus p without HCV disease (p<.004).In our prospective follow-up,90 p were evaluated for 1 year,but neither significant alterations of liver profile,nor occurence of toxic hepatitis were seen.
Conclusions: In our experience an appreciable prevalence (51.7%) of liver toxicity was observed in p receiving dual NA,although the great majority of cases had mild-moderate severity.In a multivariate analysis,serum enzyme rise was significantly more frequent in p treated with d4T,and a concurrent chronic HCV disease.However,such a condition did not show significant modifications during the subsequent 1-year follow-up
The 3rd IAS Conference on HIV Pathogenesis and Treatment
Abstract no.
TuPe2.2B02
Suggested Citation
"CalzaL., et al.
Nucleoside analogue transcriptase inhibitors and liver toxicity among patients treated for HIV disease.
Poster Exhibition:
The 3rd IAS Conference on HIV Pathogenesis and Treatment:
Abstract no.
TuPe2.2B02"
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