Hepatotoxicity associated with antiretroviral therapy containing dual versus single protease inhibitors in individuals coinfected with hepatitis C virus and human immunodeficiency virus
Hepatotoxicity associated with antiretroviral therapy containing dual versus single protease inhibitors in individuals coinfected with hepatitis C virus and human immunodeficiency virus
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DOI：
10.1086/339867
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发表时间：
2002-05-01
影响因子：
11.8
通讯作者：
Angel, JB
中科院分区：
文献类型：
--
作者：
Cooper, CL;Parbhakar, MA;Angel, JB
为确定人类免疫缺陷病毒(HIV)和丙型肝炎病毒(丙型肝炎病毒)混合感染患者因蛋白酶抑制剂(PI)相关肝毒性而停止治疗的发生率，进行了一项回顾性研究。在单一和双重PI治疗的受试者之间，以及在接受利托那韦治疗的受试者和接受非利托那韦治疗的受试者之间，基线的CD4计数、血浆HIV RNA水平和治疗持续时间是相似的。丙氨酸氨基转移酶水平高于或等于正常上限(19%对26%)和高胆红素血症(30%对38%)上限的患者在双PI组(n=27)和单一PI组(n=39)之间的比例相似。在含有利托那韦的治疗组(n=34)和保留利托那韦的治疗组(n=32)之间，这些特征没有差异。单一PI和双重PI治疗以及含有利托那韦和不使用利托那韦的方案中，因肝毒性而停止治疗的比率相似。双重PI治疗和纳入利托那韦似乎不会增加PI治疗的HIV-丙型肝炎合并感染者的肝毒性发生率。
To determine the rates of patients coinfected with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) who discontinued therapy as a result of protease inhibitor (PI)-related hepatotoxicity, a retrospective review was conducted. Baseline CD4 counts, plasma HIV RNA levels, and duration of therapy were comparable between single- and dual-PI-treated subjects and between subjects receiving ritonavir-containing therapy and those receiving ritonavir-sparing therapy. The proportions of patients with elevations in alanine aminotransferase level to greater than or equal to5 times the upper limit of normal (19% versus 26%) and hyperbilirubinemia (30% versus 38%) were similar between the dual-PI (n = 27) and single-PI treatment groups (n = 39), respectively. No difference in these characteristics was observed between ritonavir-containing (n = 34) and ritonavir-sparing (n = 32) treatment arms. Rates of treatment discontinuation due to hepatotoxicity were similar for single-PI and dual-PI therapy and for ritonavir-containing and ritonavir-sparing regimens. Dual-PI therapy and inclusion of ritonavir do not seem to increase the rates of hepatotoxicity in PI-treated, HIV-HCV coinfected subjects.