Biglino A, Degioanni M, Valle M, Crivelli P; International Conference on AIDS.

Int Conf AIDS. 2000 Jul 9-14; 13: abstract no. TuPpB1162.

A. Biglino, Ospedale Civile - ASL 19, Via Botallo 4, 14100 ASTI, Italy, Tel.: +39 141 392 340, Fax: +39 141 392 498, E-mail: infett@provinvia.asti.it

Background: The role of PI treatment in inducing liver damage in HIV/HCV coinfection is debated. Therefore, we prospectively evaluated virological, biochemical and ultrasonographic (US) parameters of liver damage in a cohort of PI-treated HIV patients with HCV-related chronic active hepatitis (CAH). Methods: 52 consecutive PI-naive patients, starting HAART for the first time or after a treatment failure, with HCV-related, biopsy-proven CAH, persistent HCV viraemia, and ALT >5x normal value, were enrolled over 90 days. HCV / HIV loads, CD4 counts, ALT, PT, and U.S. hepatic caudate/right lobe ratio (C/RLr) were evaluated monthly and at end of follow-up (FU). Results: Forty patients (32 M, 8 F; 10 A1-A2; 21 B2-B3; 9 C3; mean HCV viral load = 4.5+/-1.7 MEq/mL, HIV load = 3.81+/-1.9 log c/mL, CD4 count = 320+/-307/uL, PT = 102+/-8%, ALT = 92+/-68 U.I., C/RLr >0,65 at entry) were treated without changing schedule for 87.2+/-2 weeks (range 85-89,5) with 2 NRTI plus Indinavir (18 pts), Nelfinavir (12 pts) or Saquinavir (10 pts). Mean HCV load, HIV load, and CD4 count at the end of FU were 4.8+/-1,6 MEq/mL, 2.56+/-1,8 log copies/mL, and 357+/-290/uL, respectively (compared to baseline: "p" = 0.05, >0.05 and >0.05 by paired t-test). Liver damage parameters did not change significantly at the end of FU, either in the whole population (respectively, PT = 99+/-9% ALT = 98+/-70 U.I., C/RLr >0,65; p = n.s. by paired t-test), or according to clinical stage, HIV load at entry, or the P.I. employed. Conclusions: HIV protease inhibitors have been associated with various levels of hepatocellular damage. In this study, performed on a cohort of 40 HIV patients with HCV-related CAH prospectively followed for more than 22 months, long-term antiretroviral treatment including three different IPs does not seem to induce any significant worsening of liver damage or increase in HCV viral load.

Publication Types:

• Meeting Abstracts

Keywords:

• AIDS Vaccines
• Acquired Immunodeficiency Syndrome
• Alanine Transaminase
• Anti-HIV Agents
• Antiretroviral Therapy, Highly Active
• CD4 Lymphocyte Count
• HIV
• HIV Infections
• HIV Protease Inhibitors
• HIV Seropositivity
• Hepacivirus
• Humans
• Longitudinal Studies
• Protease Inhibitors
• United States
• Viral Load
• methods

Other ID:

• GWAIDS0001527

UI: 102239018

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