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
Hauptverfasser: 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
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container_issue 1
container_start_page 193
container_title Journal of antimicrobial chemotherapy
container_volume 68
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 &lt;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 &lt;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 ; 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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 &lt;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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ispartof Journal of antimicrobial chemotherapy, 2013-01, Vol.68 (1), p.193-199
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language eng
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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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