Liver enzyme elevation after lamivudine withdrawal in HIV-hepatitis B virus co-infected patients: the Swiss HIV Cohort Study.

Details

Serval ID
serval:BIB_7467711DBAF4
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Liver enzyme elevation after lamivudine withdrawal in HIV-hepatitis B virus co-infected patients: the Swiss HIV Cohort Study.
Journal
Hiv Medicine
Author(s)
Bellini C., Keiser O., Chave J.P., Evison J., Fehr J., Kaiser L., Weber R., Vernazza P., Bernasconi E., Telenti A., Cavassini M.
Working group(s)
Swiss HIV Cohort Study
Contributor(s)
Battegay M., Bernasconi E., Böni J., Bucher HC., Bürgisser P., Calmy A., Cattacin S., Cavassini M., Dubs R., Egger M., Elzi L., Erb P., Fischer M., Flepp M., Fontana A., Francioli P., Furrer H., Fux C., Gorgievski M., Günthard H., Hirsch H., Hirschel B., Hösli I., Kahlert C., Kaiser L., Karrer U., Kind C., Klimkait T., Ledergerber B., Martinetti G., Martinez B., Müller N., Nadal D., Opravil M., Paccaud F., Pantaleo G., Rauch A., Regenass S., Rickenbach M., Rudin C., Schmid P., Schultze D., Schüpbach J., Speck R., Taffé P., Tarr P., Telenti A., Trkola A., Vernazza P., Weber R., Yerly S.
ISSN
1468-1293 (Electronic)
ISSN-L
1464-2662
Publication state
Published
Issued date
01/2009
Volume
10
Number
1
Pages
12-18
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
Background The principal causes of liver enzyme elevation among HIV-hepatitis B virus (HBV) co-infected patients are the hepatotoxic effects of antiretroviral therapy (ART), alcohol abuse, ART-induced immune reconstitution and the exacerbation of chronic HBV infection. Objectives To investigate the incidence and severity of liver enzyme elevation, liver failure and death following lamivudine (3TC) withdrawal in HIV-HBV co-infected patients. Methods Retrospective analysis of the Swiss HIV Cohort Study database to assess the clinical and biological consequences of the discontinuation of 3TC. Variables considered for analysis included liver enzyme, HIV virological and immunological parameters, and medication prescribed during a 6-month period following 3TC withdrawal. Results 3TC was discontinued in 255 patients on 363 occasions. On 147 occasions (109 patients), a follow-up visit within 6 months following 3TC withdrawal was recorded. Among these patients, liver enzyme elevation occurred on 42 occasions (29%), three of them (2%) with severity grade III and five of them (3.4%) with severity grade IV elevations (as defined by the AIDS Clinical Trials Group). Three patients presented with fulminant hepatitis. One death (0.7%) was recorded. Conclusions HBV reactivation leading to liver dysfunction may be an under-reported consequence of 3TC withdrawal in HIV-HBV co-infected patients. Regular monitoring of HBV markers is warranted if active therapy against HBV is discontinued.
Keywords
AIDS-Related Opportunistic Infections/complications, AIDS-Related Opportunistic Infections/drug therapy, Adult, Anti-HIV Agents/therapeutic use, Antiretroviral Therapy, Highly Active, CD4 Lymphocyte Count, Epidemiologic Methods, Female, HIV-1, Hepatitis B/complications, Hepatitis B/drug therapy, Hepatitis B e Antigens/drug effects, Humans, Lamivudine/therapeutic use, Liver Diseases/drug therapy, Liver Diseases/etiology, Male, Middle Aged, Recurrence, Switzerland, Viral Load
Pubmed
Web of science
Create date
05/03/2009 16:58
Last modification date
20/08/2019 14:32
Usage data