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Increased incidence of antiretroviral drug discontinuation among patients with viremic hepatitis C virus coinfection and high hyaluronic acid, a marker of liver fibrosis

(2014) AIDS. 28(4). p.577-587
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Abstract
Background: Most antiretroviral drugs are metabolized by the liver; hepatic disease or liver damage as a result of hepatitis C virus (HCV) could impair this metabolism leading to an increased risk of drug toxicity. This study aimed to determine the risk of antiretroviral drug discontinuation among HCV/HIV coinfected patients. Methods: EuroSIDA patients taking combination antiretroviral therapy were included. Poisson regression identified factors associated with antiretroviral treatment discontinuation. Results: A total of 9535 HIV-positive patients with known HCV status were included (6939 HCVAb-negative; 2596 HCVAb-positive at baseline). Viremic HCV infection was associated with a 44% increased risk of antiretroviral drug discontinuation compared with aviremic infection [adjusted incidence rate ratio, aIRR: 1.44 (95% confidence interval, CI 1.22-1.69)]; this relationship was largest among nonnucleoside reverse transcriptase inhibitors [aIRR: 1.59 (95% CI 1.18-2.14)]. In the subset of 935 HIV-positive patients also HCV-positive or HBV-positive with plasma hyaluronic acid measured, hyaluronic acid more than 100 ng/ml was associated with a 37% increased risk of antiretroviral drug discontinuation [aIRR: 1.37 (95% CI 1.08-1.73) vs. hyaluronic acid <= 100 ng/ml] and the effect of HCV viremia became nonsignificant; the largest drug association was seen for protease inhibitors [aIRR: 1.40 (95% CI 1.04-1.89)]. Conclusion: HCV viremia and high levels of hyaluronic acid predict antiretroviral drug discontinuation. Evidence was also found to suggest a link between impaired liver function and protease inhibitor toxicity.
Keywords
HIV, treatment discontinuation, toxicity, TOXICITY, significant fibrosis, HEPATOTOXICITY, combination antiretroviral therapy, PATIENT/PHYSICIAN CHOICE, coinfection, INFECTED PATIENTS, HUMAN-IMMUNODEFICIENCY-VIRUS, NATURAL-HISTORY, PROTEASE INHIBITORS, DISEASE PROGRESSION, HIV, THERAPY, hyaluronic acid, hepatitis C virus

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Citation

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Chicago
Grint, Daniel, Lars Peters, Juergen K Rockstroh, Stephane De Wit, Victor M Mitsura, Brygida Knysz, Court Pedersen, et al. 2014. “Increased Incidence of Antiretroviral Drug Discontinuation Among Patients with Viremic Hepatitis C Virus Coinfection and High Hyaluronic Acid, a Marker of Liver Fibrosis.” Aids 28 (4): 577–587.
APA
Grint, Daniel, Peters, L., Rockstroh, J. K., De Wit, S., Mitsura, V. M., Knysz, B., Pedersen, C., et al. (2014). Increased incidence of antiretroviral drug discontinuation among patients with viremic hepatitis C virus coinfection and high hyaluronic acid, a marker of liver fibrosis. AIDS, 28(4), 577–587.
Vancouver
1.
Grint D, Peters L, Rockstroh JK, De Wit S, Mitsura VM, Knysz B, et al. Increased incidence of antiretroviral drug discontinuation among patients with viremic hepatitis C virus coinfection and high hyaluronic acid, a marker of liver fibrosis. AIDS. 2014;28(4):577–87.
MLA
Grint, Daniel, Lars Peters, Juergen K Rockstroh, et al. “Increased Incidence of Antiretroviral Drug Discontinuation Among Patients with Viremic Hepatitis C Virus Coinfection and High Hyaluronic Acid, a Marker of Liver Fibrosis.” AIDS 28.4 (2014): 577–587. Print.
@article{4352259,
  abstract     = {Background: Most antiretroviral drugs are metabolized by the liver; hepatic disease or liver damage as a result of hepatitis C virus (HCV) could impair this metabolism leading to an increased risk of drug toxicity. This study aimed to determine the risk of antiretroviral drug discontinuation among HCV/HIV coinfected patients.
Methods: EuroSIDA patients taking combination antiretroviral therapy were included. Poisson regression identified factors associated with antiretroviral treatment discontinuation.
Results: A total of 9535 HIV-positive patients with known HCV status were included (6939 HCVAb-negative; 2596 HCVAb-positive at baseline). Viremic HCV infection was associated with a 44% increased risk of antiretroviral drug discontinuation compared with aviremic infection [adjusted incidence rate ratio, aIRR: 1.44 (95% confidence interval, CI 1.22-1.69)]; this relationship was largest among nonnucleoside reverse transcriptase inhibitors [aIRR: 1.59 (95% CI 1.18-2.14)]. In the subset of 935 HIV-positive patients also HCV-positive or HBV-positive with plasma hyaluronic acid measured, hyaluronic acid more than 100 ng/ml was associated with a 37% increased risk of antiretroviral drug discontinuation [aIRR: 1.37 (95% CI 1.08-1.73) vs. hyaluronic acid <= 100 ng/ml] and the effect of HCV viremia became nonsignificant; the largest drug association was seen for protease inhibitors [aIRR: 1.40 (95% CI 1.04-1.89)].
Conclusion: HCV viremia and high levels of hyaluronic acid predict antiretroviral drug discontinuation. Evidence was also found to suggest a link between impaired liver function and protease inhibitor toxicity.},
  author       = {Grint, Daniel and Peters, Lars and Rockstroh, Juergen K and De Wit, Stephane and Mitsura, Victor M and Knysz, Brygida and Pedersen, Court and Kirk, Ole and Lundgren, Jens D and Mocroft, Amanda and EuroSIDA Study group, the and Vandekerckhove, Linos},
  issn         = {0269-9370},
  journal      = {AIDS},
  keywords     = {HIV,treatment discontinuation,toxicity,TOXICITY,significant fibrosis,HEPATOTOXICITY,combination antiretroviral therapy,PATIENT/PHYSICIAN CHOICE,coinfection,INFECTED PATIENTS,HUMAN-IMMUNODEFICIENCY-VIRUS,NATURAL-HISTORY,PROTEASE INHIBITORS,DISEASE PROGRESSION,HIV,THERAPY,hyaluronic acid,hepatitis C virus},
  language     = {eng},
  number       = {4},
  pages        = {577--587},
  title        = {Increased incidence of antiretroviral drug discontinuation among patients with viremic hepatitis C virus coinfection and high hyaluronic acid, a marker of liver fibrosis},
  url          = {http://dx.doi.org/10.1097/QAD.0000000000000069},
  volume       = {28},
  year         = {2014},
}

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