Response to raltegravir-based salvage therapy in HIV-infected patients with hepatitis C virus or hepatitis B virus coinfection
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. We used data from a national observational study of patien...
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Veröffentlicht in: | Journal of antimicrobial chemotherapy 2013-01, Vol.68 (1), p.193-199 |
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creator | Weimer, Liliana Elena Fragola, Vincenzo Floridia, Marco Guaraldi, Giovanni Ladisa, Nicoletta Francisci, Daniela Bellagamba, Rita Degli Antoni, Anna Parruti, Giustino Giacometti, Andrea Manconi, Paolo Emilio Vivarelli, Angela D'Ettorre, Gabriella Mura, Maria Stella Cicalini, Stefania Preziosi, Roberta Sighinolfi, Laura Verucchi, Gabriella Libertone, Raffaella Tavio, Marcello Sarmati, Loredana Bucciardini, Raffaella |
description | 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.
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.
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 |
doi_str_mv | 10.1093/jac/dks341 |
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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.
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.
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.</description><identifier>ISSN: 0305-7453</identifier><identifier>EISSN: 1460-2091</identifier><identifier>DOI: 10.1093/jac/dks341</identifier><identifier>PMID: 22984206</identifier><language>eng</language><publisher>England: Oxford Publishing Limited (England)</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Antiretroviral drugs ; CD4 antigen ; Cohort Studies ; Coinfection - drug therapy ; Coinfection - epidemiology ; copy number ; Data processing ; Drug abuse ; Drugs ; Female ; Follow-Up Studies ; Health risk assessment ; Hepacivirus - drug effects ; Hepatitis ; Hepatitis B ; Hepatitis B - drug therapy ; Hepatitis B - epidemiology ; Hepatitis B virus ; Hepatitis B virus - drug effects ; Hepatitis C ; Hepatitis C - drug therapy ; Hepatitis C - epidemiology ; Hepatitis C virus ; HIV ; HIV Infections - drug therapy ; HIV Infections - epidemiology ; Human immunodeficiency virus ; Humans ; Immunology ; Infection ; Intravenous administration ; Liver ; Male ; Middle Aged ; Original Research ; Salvage Therapy - methods ; Toxicity ; Treatment Outcome ; Virology ; Young Adult</subject><ispartof>Journal of antimicrobial chemotherapy, 2013-01, Vol.68 (1), p.193-199</ispartof><rights>Copyright Oxford Publishing Limited(England) Jan 2013</rights><rights>The Author 2012. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com 2012</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c439t-de12073b179f4985342ee108401c1257920ffda9b4918c31f1e5e42f22553e333</citedby><cites>FETCH-LOGICAL-c439t-de12073b179f4985342ee108401c1257920ffda9b4918c31f1e5e42f22553e333</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22984206$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Weimer, Liliana Elena</creatorcontrib><creatorcontrib>Fragola, Vincenzo</creatorcontrib><creatorcontrib>Floridia, Marco</creatorcontrib><creatorcontrib>Guaraldi, Giovanni</creatorcontrib><creatorcontrib>Ladisa, Nicoletta</creatorcontrib><creatorcontrib>Francisci, Daniela</creatorcontrib><creatorcontrib>Bellagamba, Rita</creatorcontrib><creatorcontrib>Degli Antoni, Anna</creatorcontrib><creatorcontrib>Parruti, Giustino</creatorcontrib><creatorcontrib>Giacometti, Andrea</creatorcontrib><creatorcontrib>Manconi, Paolo Emilio</creatorcontrib><creatorcontrib>Vivarelli, Angela</creatorcontrib><creatorcontrib>D'Ettorre, Gabriella</creatorcontrib><creatorcontrib>Mura, Maria Stella</creatorcontrib><creatorcontrib>Cicalini, Stefania</creatorcontrib><creatorcontrib>Preziosi, Roberta</creatorcontrib><creatorcontrib>Sighinolfi, Laura</creatorcontrib><creatorcontrib>Verucchi, Gabriella</creatorcontrib><creatorcontrib>Libertone, Raffaella</creatorcontrib><creatorcontrib>Tavio, Marcello</creatorcontrib><creatorcontrib>Sarmati, Loredana</creatorcontrib><creatorcontrib>Bucciardini, Raffaella</creatorcontrib><creatorcontrib>ISS-NIA Study Group</creatorcontrib><creatorcontrib>on behalf of the ISS-NIA Study Group</creatorcontrib><title>Response to raltegravir-based salvage therapy in HIV-infected patients with hepatitis C virus or hepatitis B virus coinfection</title><title>Journal of antimicrobial chemotherapy</title><addtitle>J Antimicrob Chemother</addtitle><description>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.
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.
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.
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.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antiretroviral drugs</subject><subject>CD4 antigen</subject><subject>Cohort Studies</subject><subject>Coinfection - drug therapy</subject><subject>Coinfection - epidemiology</subject><subject>copy number</subject><subject>Data processing</subject><subject>Drug abuse</subject><subject>Drugs</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Health risk assessment</subject><subject>Hepacivirus - drug effects</subject><subject>Hepatitis</subject><subject>Hepatitis B</subject><subject>Hepatitis B - drug therapy</subject><subject>Hepatitis B - epidemiology</subject><subject>Hepatitis B virus</subject><subject>Hepatitis B virus - drug effects</subject><subject>Hepatitis C</subject><subject>Hepatitis C - drug therapy</subject><subject>Hepatitis C - epidemiology</subject><subject>Hepatitis C virus</subject><subject>HIV</subject><subject>HIV Infections - drug therapy</subject><subject>HIV Infections - epidemiology</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Immunology</subject><subject>Infection</subject><subject>Intravenous administration</subject><subject>Liver</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Original Research</subject><subject>Salvage Therapy - methods</subject><subject>Toxicity</subject><subject>Treatment Outcome</subject><subject>Virology</subject><subject>Young Adult</subject><issn>0305-7453</issn><issn>1460-2091</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkk-LFDEQxYMo7rh68QNIwIsI7Vb-dXcuwjqou7AgiHoNmXT1TMaeTpukR_biZzfDjMvqyVNIvV8eValHyHMGbxhocbG17qL7noRkD8iCyRoqDpo9JAsQoKpGKnFGnqS0BYBa1e1jcsa5biWHekF-fcY0hTEhzYFGO2RcR7v3sVrZhB1NdtjbdRE3GO10S_1Ir66_VX7s0eWiTzZ7HHOiP33e0A0e7tknuqTFY040xHvFd6eiC8f3PoxPyaPeDgmfnc5z8vXD-y_Lq-rm08fr5eVN5aTQueqQcWjEijW6l7pVQnJEBq0E5hhXjebQ953VK6lZ6wTrGSqUvOdcKYFCiHPy9ug7zasddq70XIY1U_Q7G29NsN78rYx-Y9Zhb4TiXMq6GLw6GcTwY8aUzc4nh8NgRwxzMoy3CtpW1_p_UNFwJZqD68t_0G2Y41h-olAShCpLgkK9PlIuhpQi9nd9MzCHBJiSAHNMQIFf3J_0Dv2zcvEbJMat9g</recordid><startdate>20130101</startdate><enddate>20130101</enddate><creator>Weimer, Liliana Elena</creator><creator>Fragola, Vincenzo</creator><creator>Floridia, Marco</creator><creator>Guaraldi, Giovanni</creator><creator>Ladisa, Nicoletta</creator><creator>Francisci, Daniela</creator><creator>Bellagamba, Rita</creator><creator>Degli Antoni, Anna</creator><creator>Parruti, Giustino</creator><creator>Giacometti, Andrea</creator><creator>Manconi, Paolo Emilio</creator><creator>Vivarelli, Angela</creator><creator>D'Ettorre, Gabriella</creator><creator>Mura, Maria Stella</creator><creator>Cicalini, Stefania</creator><creator>Preziosi, Roberta</creator><creator>Sighinolfi, Laura</creator><creator>Verucchi, Gabriella</creator><creator>Libertone, Raffaella</creator><creator>Tavio, Marcello</creator><creator>Sarmati, Loredana</creator><creator>Bucciardini, Raffaella</creator><general>Oxford Publishing Limited (England)</general><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>7QO</scope><scope>7T7</scope><scope>7U7</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20130101</creationdate><title>Response to raltegravir-based salvage therapy in HIV-infected patients with hepatitis C virus or hepatitis B virus coinfection</title><author>Weimer, Liliana Elena ; Fragola, Vincenzo ; Floridia, Marco ; Guaraldi, Giovanni ; Ladisa, Nicoletta ; Francisci, Daniela ; Bellagamba, Rita ; Degli Antoni, Anna ; Parruti, Giustino ; Giacometti, Andrea ; Manconi, Paolo Emilio ; Vivarelli, Angela ; D'Ettorre, Gabriella ; Mura, Maria Stella ; Cicalini, Stefania ; Preziosi, Roberta ; Sighinolfi, Laura ; Verucchi, Gabriella ; Libertone, Raffaella ; Tavio, Marcello ; Sarmati, Loredana ; Bucciardini, Raffaella</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c439t-de12073b179f4985342ee108401c1257920ffda9b4918c31f1e5e42f22553e333</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Antiretroviral drugs</topic><topic>CD4 antigen</topic><topic>Cohort Studies</topic><topic>Coinfection - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of antimicrobial chemotherapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Weimer, Liliana Elena</au><au>Fragola, Vincenzo</au><au>Floridia, Marco</au><au>Guaraldi, Giovanni</au><au>Ladisa, Nicoletta</au><au>Francisci, Daniela</au><au>Bellagamba, Rita</au><au>Degli Antoni, Anna</au><au>Parruti, Giustino</au><au>Giacometti, Andrea</au><au>Manconi, Paolo Emilio</au><au>Vivarelli, Angela</au><au>D'Ettorre, Gabriella</au><au>Mura, Maria Stella</au><au>Cicalini, Stefania</au><au>Preziosi, Roberta</au><au>Sighinolfi, Laura</au><au>Verucchi, Gabriella</au><au>Libertone, Raffaella</au><au>Tavio, Marcello</au><au>Sarmati, Loredana</au><au>Bucciardini, Raffaella</au><aucorp>ISS-NIA Study Group</aucorp><aucorp>on behalf of the ISS-NIA Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Response to raltegravir-based salvage therapy in HIV-infected patients with hepatitis C virus or hepatitis B virus coinfection</atitle><jtitle>Journal of antimicrobial chemotherapy</jtitle><addtitle>J Antimicrob Chemother</addtitle><date>2013-01-01</date><risdate>2013</risdate><volume>68</volume><issue>1</issue><spage>193</spage><epage>199</epage><pages>193-199</pages><issn>0305-7453</issn><eissn>1460-2091</eissn><abstract>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.
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.
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.
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.</abstract><cop>England</cop><pub>Oxford Publishing Limited (England)</pub><pmid>22984206</pmid><doi>10.1093/jac/dks341</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection; Free Full-Text Journals in Chemistry |
subjects | Adult Aged Aged, 80 and over Antiretroviral drugs CD4 antigen Cohort Studies Coinfection - drug therapy Coinfection - epidemiology copy number Data processing Drug abuse Drugs Female Follow-Up Studies Health risk assessment Hepacivirus - drug effects Hepatitis Hepatitis B Hepatitis B - drug therapy Hepatitis B - epidemiology Hepatitis B virus Hepatitis B virus - drug effects Hepatitis C Hepatitis C - drug therapy Hepatitis C - epidemiology Hepatitis C virus HIV HIV Infections - drug therapy HIV Infections - epidemiology Human immunodeficiency virus Humans Immunology Infection Intravenous administration Liver Male Middle Aged Original Research Salvage Therapy - methods Toxicity Treatment Outcome Virology Young Adult |
title | Response to raltegravir-based salvage therapy in HIV-infected patients with hepatitis C virus or hepatitis B virus coinfection |
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