Hepatitis B or Hepatitis C Virus Infection Is a Risk Factor for Severe Hepatic Cytolysis after Initiation of a Protease Inhibitor-Containing Antiretroviral Regimen in Human Immunodeficiency Virus-Infected Patients
Saves, M.; Raffi, F.; Clevenbergh, P.; Marchou, B.; Waldner-Combernoux, A.; Morlat, P.; LeMoing, V.; Riviere, C.; Chene, G.; Leport, C.; The APROCOStudy Group,
Antimicrobial Agents and Chemotherapy 44(12): 3451-3455
2000
ISSN/ISBN: 0066-4804 DOI: 10.1128/aac.44.12.3451-3455.2000Document Number: 578817
In a cohort of 1,047 human immunodeficiency virus type 1-infected patients started on protease inhibitors (PIs), the incidence of severe hepatic cytolysis (alanine aminotransferase concentration five times or more above the upper limit of the normal level >/= 5N) was 5% patient-years after a mean follow-up of 5 months. Only positivity for hepatitis C virus antibodies (hazard ratio [HR], 7. 95; P < 10(-3)) or hepatitis B virus surface antigen (HR, 6.67; P < 10(-3)) was associated with severe cytolysis. Before starting patients on PIs, assessment of liver enzyme levels and viral coinfections is necessary.
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