Hepatotoxicity development during antiretroviral therapy containing protease inhibitors in patients with HIV

The role of hepatitis B and C virus infection

Antonio Aceti, Caterina Pasquazzi, Barbara Zechini, Carlo De Bac, A. Cargnel, R. Giorgi, G. Carosi, C. Torti, F. Chiodo, R. Giuliani, E. Concia, F. Cainelli, F. Ghinelli, R. Roda, F. Mazzotta, L. Pierotti, F. Milazzo, I. Fagion, L. Minoli, L. Rizzi & 14 others M. S. Mura, G. Sotgiu, L. Ortona, S. Di Gianbenedetto, G. Pastore, R. Cavaliere, M. Piazza, L. Maddaloni, E. Sagnelli, C. Nacca, G. Scalise, M. S. Del Prete, V. Vullo, P. Santopadre

Research output: Contribution to journalArticle

156 Citations (Scopus)

Abstract

To evaluate the occurrence of hepatotoxicity in patients during antiretroviral therapy (ART) that contains protease inhibitors and the role of hepatitis viruses in its development, we performed a retrospective study including 1325 HIV-infected patients treated with ART for at least 6 months. Presence or absence of hepatitis viruses, alanine aminotransferase (ALT), total bilirubin, CD4 cell count, and plasma HIV RNA levels were evaluated. Hepatotoxicity developed in a few study subjects without coinfection, whereas it was significantly higher in coinfected patients. Univariate logistic regression analysis showed that viral hepatitis coinfections are independent risk factors for hepatotoxicity. After 6 months of treatment, ritonavir was associated with higher rates of severe hepatotoxicity in the coinfected group; in fact, ritonavir seems to be the most strongly hepatotoxic agent among coinfected patients. After 12 months of therapy, hepatotoxicity occurred more frequently in patients with hepatitis C virus who did not respond to antiretroviral therapy (ART), whereas patients who did respond to ART showed decreased ALT levels. Hepatotoxicity is not exclusively an effect of drug toxicity, and the presence of hepatitis coinfection is an independent risk factor. Moreover, chronic hepatotoxicity mainly occurs in patients who did not respond to therapy. Conversely, patients who did respond to ART seemed to show improvement of chronic liver infection.

Original languageEnglish
Pages (from-to)41-48
Number of pages8
JournalJournal of Acquired Immune Deficiency Syndromes
Volume29
Issue number1
Publication statusPublished - Jan 1 2002
Externally publishedYes

Fingerprint

Virus Diseases
Protease Inhibitors
Hepatitis B virus
Hepacivirus
HIV
Coinfection
Ritonavir
Hepatitis Viruses
Therapeutics
Alanine Transaminase
Hepatitis
CD4 Lymphocyte Count
Drug-Related Side Effects and Adverse Reactions
Bilirubin
Retrospective Studies
Logistic Models
Regression Analysis
RNA
Liver
Infection

Keywords

  • ART
  • Hepatitis C or B virus
  • Hepatotoxicity
  • HIV
  • Protease inhibitors

ASJC Scopus subject areas

  • Virology
  • Immunology

Cite this

Hepatotoxicity development during antiretroviral therapy containing protease inhibitors in patients with HIV : The role of hepatitis B and C virus infection. / Aceti, Antonio; Pasquazzi, Caterina; Zechini, Barbara; De Bac, Carlo; Cargnel, A.; Giorgi, R.; Carosi, G.; Torti, C.; Chiodo, F.; Giuliani, R.; Concia, E.; Cainelli, F.; Ghinelli, F.; Roda, R.; Mazzotta, F.; Pierotti, L.; Milazzo, F.; Fagion, I.; Minoli, L.; Rizzi, L.; Mura, M. S.; Sotgiu, G.; Ortona, L.; Di Gianbenedetto, S.; Pastore, G.; Cavaliere, R.; Piazza, M.; Maddaloni, L.; Sagnelli, E.; Nacca, C.; Scalise, G.; Del Prete, M. S.; Vullo, V.; Santopadre, P.

In: Journal of Acquired Immune Deficiency Syndromes, Vol. 29, No. 1, 01.01.2002, p. 41-48.

Research output: Contribution to journalArticle

Aceti, A, Pasquazzi, C, Zechini, B, De Bac, C, Cargnel, A, Giorgi, R, Carosi, G, Torti, C, Chiodo, F, Giuliani, R, Concia, E, Cainelli, F, Ghinelli, F, Roda, R, Mazzotta, F, Pierotti, L, Milazzo, F, Fagion, I, Minoli, L, Rizzi, L, Mura, MS, Sotgiu, G, Ortona, L, Di Gianbenedetto, S, Pastore, G, Cavaliere, R, Piazza, M, Maddaloni, L, Sagnelli, E, Nacca, C, Scalise, G, Del Prete, MS, Vullo, V & Santopadre, P 2002, 'Hepatotoxicity development during antiretroviral therapy containing protease inhibitors in patients with HIV: The role of hepatitis B and C virus infection', Journal of Acquired Immune Deficiency Syndromes, vol. 29, no. 1, pp. 41-48.
Aceti, Antonio ; Pasquazzi, Caterina ; Zechini, Barbara ; De Bac, Carlo ; Cargnel, A. ; Giorgi, R. ; Carosi, G. ; Torti, C. ; Chiodo, F. ; Giuliani, R. ; Concia, E. ; Cainelli, F. ; Ghinelli, F. ; Roda, R. ; Mazzotta, F. ; Pierotti, L. ; Milazzo, F. ; Fagion, I. ; Minoli, L. ; Rizzi, L. ; Mura, M. S. ; Sotgiu, G. ; Ortona, L. ; Di Gianbenedetto, S. ; Pastore, G. ; Cavaliere, R. ; Piazza, M. ; Maddaloni, L. ; Sagnelli, E. ; Nacca, C. ; Scalise, G. ; Del Prete, M. S. ; Vullo, V. ; Santopadre, P. / Hepatotoxicity development during antiretroviral therapy containing protease inhibitors in patients with HIV : The role of hepatitis B and C virus infection. In: Journal of Acquired Immune Deficiency Syndromes. 2002 ; Vol. 29, No. 1. pp. 41-48.
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