Document Detail


Response to raltegravir-based salvage therapy in HIV-infected patients with hepatitis C virus or hepatitis B virus coinfection.
MedLine Citation:
PMID:  22984206     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To define the impact of coinfection with hepatitis B virus (HBV) or hepatitis C virus (HCV) on viroimmunological response to raltegravir-based salvage regimens that also include new HIV inhibitors such as maraviroc, darunavir and etravirine.
METHODS: We used data from a national observational study of patients starting raltegravir-based regimens to compare virological suppression and CD4 cell change from baseline in patients with and without concomitant HBV or HCV infection.
RESULTS: Overall, 275 patients (107 coinfected and 168 non-coinfected) were evaluated. Coinfected patients were more commonly former intravenous drug users and had a longer history of HIV infection and higher baseline aminotransferase levels. Both HIV-RNA and CD4 response were similar in the two groups. Mean time to first HIV-RNA copy number <50 copies/mL was 4.1 months (95% CI 3.5-4.6) in non-coinfected patients and 3.9 months (95% CI 3.3-4.5) in coinfected patients (hazard ratio 1.039, 95% CI 0.761-1.418, P = 0.766, log-rank test). The risk of developing new grade 3-4 hepatic adverse events was significantly higher in coinfected patients (hazard ratio 1.779, 95% CI 1.123-2.817, P = 0.009). The two groups of coinfected and non-coinfected patients had similar rates of interruption of any baseline drug (hazard ratio 1.075, 95% CI 0.649-1.781, P = 0.776) and of raltegravir (hazard ratio 1.520, 95% CI 0.671-3.447, P = 0.311). Few AIDS-defining events and deaths occurred.
CONCLUSIONS: Viroimmunological response to regimens based on raltegravir and other recent anti-HIV inhibitors is not negatively affected by coinfection with HBV or HCV. Liver toxicity, either pre-existing or new, is more common in coinfected patients, but with no increased risk of treatment interruption.
Authors:
Liliana Elena Weimer; Vincenzo Fragola; Marco Floridia; Giovanni Guaraldi; Nicoletta Ladisa; Daniela Francisci; Rita Bellagamba; Anna Degli Antoni; Giustino Parruti; Andrea Giacometti; Paolo Emilio Manconi; Angela Vivarelli; Gabriella D'Ettorre; Maria Stella Mura; Stefania Cicalini; Roberta Preziosi; Laura Sighinolfi; Gabriella Verucchi; Raffaella Libertone; Marcello Tavio; Loredana Sarmati; Raffaella Bucciardini;
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-09-14
Journal Detail:
Title:  The Journal of antimicrobial chemotherapy     Volume:  68     ISSN:  1460-2091     ISO Abbreviation:  J. Antimicrob. Chemother.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2012-12-17     Completed Date:  2013-09-23     Revised Date:  2014-01-09    
Medline Journal Info:
Nlm Unique ID:  7513617     Medline TA:  J Antimicrob Chemother     Country:  England    
Other Details:
Languages:  eng     Pagination:  193-9     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Cohort Studies
Coinfection / drug therapy*,  epidemiology
Female
Follow-Up Studies
HIV Infections / drug therapy*,  epidemiology
Hepacivirus / drug effects
Hepatitis B / drug therapy*,  epidemiology
Hepatitis B virus / drug effects
Hepatitis C / drug therapy*,  epidemiology
Humans
Male
Middle Aged
Salvage Therapy / methods*
Treatment Outcome
Young Adult
Investigator
Investigator/Affiliation:
G Angarano / ; N Ladisa / ; A Volpe / ; V Vullo / ; G D'Ettorre / ; G Ceccarelli / ; M Andreoni / ; L Sarmati / ; D Delle Rose / ; V Tozzi / ; P Narciso / ; N Petrosillo / ; V Pucillo / ; R Bellagamba / ; R Libertone / ; S Cicalini / ; C Tommasi / ; L Sighinolfi / ; D Segala / ; O Armignacco / ; R Preziosi / ; C Ferrari / ; A Degli Antoni / ; A Cavalli / ; G Parruti / ; F Sozio / ; L Cosentino / ; A Vivarelli / ; P E Manconi / ; F Ortu / ; P Viale / ; G Verucchi / ; S Tedeschi / ; R Manfredi / ; S Orsola / ; M S Mura / ; M Mannazzu / ; G Cattari / ; M Tavio / ; R Del Gobbo / ; A Mataloni Paggi / ; A Giacometti / ; O Cirioni / ; E Marchionni / ; C Silvestri / ; L Brescini / ; S Sebastianelli / ; F Baldelli / ; D Francisci / ; A Mercuri / ; S Bastianelli / ; G Guaraldi / ; G Nardini / ; R Bucciardini / ; M Floridia / ; L E Weimer / ; V Fragola / ; M Massella / ; S Baroncelli / ; C M Galluzzo / ; M F Pirillo / ; M G Mancini / ; R Amici / ; A Cara / ; R Bona / ; P Leone / ; P Filati / ; M Franco / ; S Donnini /
Comments/Corrections

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