Influence of genotype 3 hepatitis C coinfection on liver enzyme elevation in HIV-1-positive patients after commencement of a new highly active antiretroviral regimen: Results from the EPOKA-MASTER cohort

Carlo Torti, Giuseppe Lapadula, Massimo Puoti, Salvatore Casari, Maria Cristina Uccelli, Graziella Cristini, Daniele Bella, Giuseppe Pastore, Nicoletta Ladisa, Lorenzo Minoli, Giovanni Sotgiu, Sergio Lo Caputo, Stefano Bonora, Giampiero Carosi

Research output: Contribution to journalArticle

Abstract

Background: The independent role of hepatitis C virus (HCV) genotype 3 in liver transaminase elevation following highly active antiretroviral regimens is still controversial. Methods: Analysis of data from a cohort of 492 HIV/HCV-coinfected patients was conducted using an intention-to-treat approach. Incidence of grade ≥III liver transaminase elevation was estimated per 100 patient-years of follow-up. Univariate and multiple proportional hazards regression analysis of factors that may predict liver enzyme elevation was performed. Results: The incidence of grade ≥III hepatotoxicity was 25 per 100 patient-years among patients coinfected with HCV genotype 3 and 11 per 100 patient-years among those with other genotypes. On multiple proportional hazard regression analysis, time-to-grade ≥III liver enzyme elevation was directly correlated with HCV genotype 3 (hazards ratio [HR]: 2.0, 95% CI: 1.3 to 2.9; P = 0.001), male gender (HR: 2.7; 95% CI: 1.3 to 5.7; P = 0.007), chronic hepatitis B virus infection (HR: 2.9, 95% CI: 1.5 to 5.9; P = 0.002), and alanine aminotransferase level at baseline (per 10 IU/L HR: 1.10; 95% CI: 1.06 to 1.15; P <0.001). In the same model, higher CD4 + T-cell counts at baseline were inversely correlated with risk of hepatotoxicity (HR: 0.998; 95% CI: 0.997 to 0.999; P = 0.036). Moreover, among patients experienced to antiretroviral drugs, previous grade ≥III hepatotoxicity (HR: 2.8; 95% CI: 1.8 to 4.3; P <0.001) was an adjunctive independent risk factor. Conclusions: HIV-positive patients coinfected with HCV genotype 3 displayed a higher risk of relevant hepatotoxicity, independently from other clinical variables. The impact of HCV genotype outweighed the role of drugs in determining hepatotoxicity.

Original languageEnglish
Pages (from-to)180-185
Number of pages6
JournalJournal of Acquired Immune Deficiency Syndromes
Volume41
Issue number2
DOIs
Publication statusPublished - Feb 2006

Keywords

  • Hepatitis C virus
  • Hepatitis C virus genotypes
  • Hepatotoxicity
  • Highly active antiretroviral therapy
  • HIV

ASJC Scopus subject areas

  • Virology
  • Immunology

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    Torti, C., Lapadula, G., Puoti, M., Casari, S., Uccelli, M. C., Cristini, G., Bella, D., Pastore, G., Ladisa, N., Minoli, L., Sotgiu, G., Caputo, S. L., Bonora, S., & Carosi, G. (2006). Influence of genotype 3 hepatitis C coinfection on liver enzyme elevation in HIV-1-positive patients after commencement of a new highly active antiretroviral regimen: Results from the EPOKA-MASTER cohort. Journal of Acquired Immune Deficiency Syndromes, 41(2), 180-185. https://doi.org/10.1097/01.qai.0000192005.08153.a3