Antiretroviral drug-related liver mortality among HIV-positive persons in the absence of hepatitis B or C virus coinfection: the data collection on adverse events of anti-HIV drugs study
Helen Kovari, Caroline A Sabin, Bruno Ledergerber, Lene Ryom, Signe W Worm, Colette Smith, Andrew Phillips, Peter Reiss, Eric Fontas, Kathy Petoumenos, Stéphane De Wit, Philippe Morlat, Jens D Lundgren, Rainer Weber, Helen Kovari, Caroline A Sabin, Bruno Ledergerber, Lene Ryom, Signe W Worm, Colette Smith, Andrew Phillips, Peter Reiss, Eric Fontas, Kathy Petoumenos, Stéphane De Wit, Philippe Morlat, Jens D Lundgren, Rainer Weber
Abstract
Background: Liver diseases are the leading causes of death in human immunodeficiency virus (HIV)-positive persons since the widespread use of combination antiretroviral treatment (cART). Most of these deaths are due to hepatitis C (HCV) or B (HBV) virus coinfections. Little is known about other causes. Prolonged exposure to some antiretroviral drugs might increase hepatic mortality.
Methods: All patients in the Data Collection on Adverse Events of Anti-HIV Drugs study without HCV or HBV coinfection were prospectively followed from date of entry until death or last follow-up. In patients with liver-related death, clinical charts were reviewed using a structured questionnaire.
Results: We followed 22 910 participants without hepatitis virus coinfection for 114 478 person-years. There were 12 liver-related deaths (incidence, 0.10/1000 person-years); 7 due to severe alcohol use and 5 due to established ART-related toxicity. The rate of ART-related deaths in treatment-experienced persons was 0.04/1000 person-years (95% confidence interval, .01, .10).
Conclusions: We found a low incidence of liver-related deaths in HIV-infected persons without HCV or HBV coinfection. Liver-related mortality because of ART-related toxicity was rare.
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Source: PubMed