Hepatotoxicity following nevirapine-containing regimens in HIV-1-infected individuals
Hepatotoxicity following nevirapine-containing regimens in HIV-1-infected individuals
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DOI：
10.1016/s1043-6618(02)00146-9
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发表时间：
2002-09-01
影响因子：
9.3
通讯作者：
Beijnen, JH
中科院分区：
文献类型：
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作者：
De Maat, MMR;Mathôt, RAA;Beijnen, JH
为了确定肝毒性的发生率，并研究血浆奈韦拉平浓度以及其他危险因素是否可以预测含奈韦拉平方案治疗期间的肝毒性，我们对174例人类免疫缺陷病毒-1 （HIV-1）感染者的数据进行了回顾性分析。定期到门诊采血，检测奈韦拉平血药浓度及肝酶（LEs）、总胆红素（TBR）等临床化学参数。严重肝毒性被定义为在治疗期间至少有一个测试的LEs或TBR水平大于或等于3级升高。预测因素的分析集中在天冬氨酸转氨酶（ASAT）和/或丙氨酸转氨酶（ALAT）升高到大于或等于2级。大于或等于3级升高，发生率为0.15 /患者年（PY）；只有3.4%的患者ASAT和/或ALAT分级大于或等于3（发生率0.03 / PY）。我们发现，在含奈韦拉平方案中使用蛋白酶抑制剂（PI）的患者和患有慢性乙型肝炎（HBV）感染的患者ASAT和/或ALAT增加到大于或等于2级的风险更高。相反，奈韦拉平的血浆浓度在本研究人群中似乎不是一个预测因素。(C) 2002 Elsevier Science Ltd.版权所有。
To determine the incidence of hepatotoxicity and to investigate whether plasma concentrations of nevirapine, in addition to other risk factors, could predict hepatotoxicity during treatment with nevirapine-containing regimens, we conducted a retrospective analysis with data from 174 individuals infected with human immunodeficiency virus-1 (HIV-1). During regular visits to the clinic, blood samples were collected for the determination of nevirapine plasma concentrations and clinical chemistry parameters including liver enzymes (LEs) and total bilirubin (TBR). Severe hepatotoxicity was defined as a grade greater than or equal to3 elevation in at least one of the tested LEs or TBR levels while on therapy. Analysis of predictive factors was focused on increases in aspartate aminotransferase (ASAT) and/or alanine aminotransferase (ALAT) to grade greater than or equal to2. Grade greater than or equal to3 elevation developed with an incidence of 0.15 per patient year (PY); only 3.4% of the patients developed grade greater than or equal to 3 values for ASAT and/or ALAT (incidence 0.03 per PY). We found that patients who use a protease inhibitor (PI) in a nevirapine-containing regimen and patients who have chronic hepatitis B (HBV) infection are at a higher risk for the development of increases in ASAT and/or ALAT to grade greater than or equal to2. In contrast, the plasma concentration of nevirapine does not appear to be a predictive factor in this study population. (C) 2002 Elsevier Science Ltd. All rights reserved.