HAART and liver: is it safe?

Authors

  • Vicente Sperb Antonello Hospital Fêmina, Porto Alegre, RS, Brasil
  • Dimas Alexandre Kliemann Hospital Nossa Senhora da Conceição, Porto Alegre, RS, Brasil
  • Breno Rigel Santos Hospital Nossa Senhora da Conceição, Porto Alegre, RS, Brasil
  • Cristiane Valle Tovo Hospital Nossa Senhora da Conceição, Porto Alegre, RS, Brasil

DOI:

https://doi.org/10.3855/jidc.5012

Keywords:

hepatotoxicity, HIV, hepatitis C, HAART

Abstract

Introduction: Liver disease caused by hepatitis C virus (HCV) is a major cause of morbidity in HIV patients. This study investigates the possibility that chronic HCV increases the risk of hepatotoxicity after highly active antiretroviral therapy (HAART) initiation.

Methodology: The data from 30 coinfected HIV/HCV and 35 HIV monoinfected patients between August 2008 and August 2010, since the start of HAART, were analyzed along with data from every three months, with clinical/laboratory evaluation until the end of twelve months. The aim of this study was to assess risk and incidence of hepatotoxicity in both groups.

Results: Before the introduction of HAART, coinfected patients had higher average levels of transaminases than did the monoinfected group (p < 0.001). After initiation of HAART, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were higher in coinfected patients, regardless of type of HAART they received. Twenty-two (73%) of the coinfected patients had some degree of hepatotoxicity versus only seven (20%) of the monoinfected patients. No patient had severe hepatotoxicity. Risk of hepatotoxicity after HAART in a coinfected patient was 3.7 times higher than in a monoinfected patient (RR 3.7 [1.8–7.4], p < 0.001).

Conclusions: This study demonstrates that coinfected patients are at an increased risk for developing hepatotoxicity, but the clinical and immunological benefits of HAART are higher than the risk of hepatotoxicity and rarely justify discontinuation of therapy.

 

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Published

2014-11-13

How to Cite

1.
Antonello VS, Kliemann DA, Rigel Santos B, Tovo CV (2014) HAART and liver: is it safe?. J Infect Dev Ctries 8:1444–1450. doi: 10.3855/jidc.5012

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Section

Original Articles