2009 |
Moodie, Erica E M; Pai, Nitika Pant; Klein, Marina B Is antiretroviral therapy causing long-term liver damage? A comparative analysis of HIV-mono-infected and HIV/Hepatitis C co-infected Cohorts Journal Article PLoS One, 4 (2), 2009. Abstract | Links | BibTeX | Tags: Antiretroviral therapy, HIV mono-infection, HIV-HCV co-infection, Liver damage @article{Moodie2009, title = {Is antiretroviral therapy causing long-term liver damage? A comparative analysis of HIV-mono-infected and HIV/Hepatitis C co-infected Cohorts}, author = {Erica E. M. Moodie and Nitika Pant Pai and Marina B. Klein}, url = {https://www.ncbi.nlm.nih.gov/pubmed/19223976}, doi = {10.1371/journal.pone.0004517}, year = {2009}, date = {2009-02-18}, journal = {PLoS One}, volume = {4}, number = {2}, abstract = {The effects of highly active antiretroviral therapy (HAART) on progression of hepatic fibrosis in HIV-hepatitis C virus (HCV) co-infection are not well understood. Deaths from liver diseases have risen in the post-HAART era, yet some cross-sectional studies have suggested that HAART use is associated with improved fibrosis rates. In a retrospective cohort of 533 HIV mono-infected and 127 HIV/HCV co-infected patients, followed between January 1991 and July 2005 at a university-based HIV clinic, we investigated the relationship between cumulative HAART exposure and hepatic fibrosis, as measured by the aspartate aminotransferase-to-platelet ratio index (APRI). We used a novel methodological approach to estimate the dose-response relationship of the effect of HAART exposure on APRI. HAART was associated with increasing APRI over time in HIV/HCV co-infected patients suggesting that they may be experiencing cumulative hepatotoxicity from antiretrovirals. The estimated median change (95% confidence interval) in APRI per one year of HAART intake was of -0.46% (-1.61% to 0.71%) in HIV mono-infected compared to 2.54% (-1.77% to 7.03%) in HIV/HCV co-infected patients. Similar results were found when the direct effect of HAART intake since the last visit was estimated on the change in APRI. HAART use associated is with increased APRI in patients with HIV/HCV co-infection. Therefore treatment for HCV infection may be required to slow the growing epidemic of end-stage liver disease in this population.}, keywords = {Antiretroviral therapy, HIV mono-infection, HIV-HCV co-infection, Liver damage}, pubstate = {published}, tppubtype = {article} } The effects of highly active antiretroviral therapy (HAART) on progression of hepatic fibrosis in HIV-hepatitis C virus (HCV) co-infection are not well understood. Deaths from liver diseases have risen in the post-HAART era, yet some cross-sectional studies have suggested that HAART use is associated with improved fibrosis rates. In a retrospective cohort of 533 HIV mono-infected and 127 HIV/HCV co-infected patients, followed between January 1991 and July 2005 at a university-based HIV clinic, we investigated the relationship between cumulative HAART exposure and hepatic fibrosis, as measured by the aspartate aminotransferase-to-platelet ratio index (APRI). We used a novel methodological approach to estimate the dose-response relationship of the effect of HAART exposure on APRI. HAART was associated with increasing APRI over time in HIV/HCV co-infected patients suggesting that they may be experiencing cumulative hepatotoxicity from antiretrovirals. The estimated median change (95% confidence interval) in APRI per one year of HAART intake was of -0.46% (-1.61% to 0.71%) in HIV mono-infected compared to 2.54% (-1.77% to 7.03%) in HIV/HCV co-infected patients. Similar results were found when the direct effect of HAART intake since the last visit was estimated on the change in APRI. HAART use associated is with increased APRI in patients with HIV/HCV co-infection. Therefore treatment for HCV infection may be required to slow the growing epidemic of end-stage liver disease in this population. |
Research Papers
2009 |
Is antiretroviral therapy causing long-term liver damage? A comparative analysis of HIV-mono-infected and HIV/Hepatitis C co-infected Cohorts Journal Article PLoS One, 4 (2), 2009. |