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Abstract
Influence of chronic viral hepatitis coinfection on the hepatotoxicity of antiretroviral therapy including ritonavir-boosted tipranavir (TPV/r)
J. Macías1, A. Rivero2, F. Orihuela3, M. Ríos4, M. Márquez5, J. Portilla6, L. Muñoz7, P. Viciana8, J. de la Torre9, J. Pasquau10, D. Merino11, A. Terrón12, J. Hernández-Burruezo13, C. Gálvez14, L. Abdel-Kader1, J.A. Pineda1, Hepatip Study Group
Background: Data on the hepatic safety of TPV/r comes mostly from clinical trials. The liver tolerability of TPV/r in real life conditions of use could be worse. However, there is little data on this issue from clinical cohorts. Because of these, we evaluated the incidence and risk factors of severe liver events among HIV-infected patients treated with drug combinations including TPV/r.
Methods: One hundred and fifty patients were selected because they started a regimen that included TPV/r (500/200 mg bid), and had clinical visits at least every three months. Patients who discontinued TPV/r due to any reason before their first visit were included. For patients with hepatitis B virus (HBV) and/or hepatitis C virus (HCV) infection, baseline liver fibrosis was evaluated using biopsy, transient elastometry or blood tests.
Results: HCV infection was present in 70 (47%) patients and HBV infection in 11 (7%) patients. Twelve (8%) individuals developed grade 3-4 transaminase elevation (TE). Nine (6%) patients discontinued TPV/r due to liver events. Four (2.7%) patients died, one due to a liver disease complication. The frequency of severe TE was similar for patients with and without HCV coinfection, six (8.6%) vs. six (7.5%), respectively (p=1). Liver fibrosis was evaluable in 48 (63%) of 76 individuals with HBV and/or HCV infection. Absent to mild fibrosis (F0-F1) was found in 18 (38%) of them and moderate to severe fibrosis (F2-F4) in 30 (62%) of them. Four (13%) subjects with F2-F4 and none with F0-F1 showed grade 3-4 TE (p=0.3). None of nine patients with cirrhosis showed grade 3-4 TE.
Conclusions: The liver tolerability of TPV/r was generally good in a cohort of patients with a high proportion of HBV and/or HCV coinfection, including subjects with advanced fibrosis. The presence of HCV coinfection was not associated with an increased risk of severe TE.
AIDS 2008 - XVII International AIDS Conference
Abstract no.
CDB0469
Suggested Citation
"J.Macías, et al.
Influence of chronic viral hepatitis coinfection on the hepatotoxicity of antiretroviral therapy including ritonavir-boosted tipranavir (TPV/r).
:
AIDS 2008 - XVII International AIDS Conference:
Abstract no.
CDB0469"
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