Abstract:
OBJECTIVES:Despite the benefits of HAART, initiation of antiretroviral therapy in HIV-HCV co-infected patients is often delayed as a consequence of patient and physician concern pertaining to liver toxicity. It is unclear whether this is justified. METHODS:We retrospectively evaluated treatment duration and outcome in 186 patients initiating a first HAART regimen. RESULTS:Despite frequent HIV RNA suppression and CD4 T-cell increase following initiation of HAART, the median duration of therapy was only 8 months. Therapy was discontinued primarily for gastrointestinal intolerance (26%), poor adherence (19%), neurocognitive side effects (13%), and substance abuse (6%). Regimes were changed to reduce pill burden and/or frequency of dosing as well (11%). Only six (4%) subjects interrupted therapy as a result of clinically apparent liver toxicity. None were on low dose ritonavir-containing therapy. In those subjects remaining on HAART for at least 12 months, the median ALT level increased marginally from a baseline of 44 IU/mL to 56 IU/mL. The median AST was 44 IU/mL at baseline and at month 12. CONCLUSIONS:These results support our contention that regimen potency, durability, and extrahepatic side effect profile should remain the paramount considerations related to the selection of HAART regimen in HIV-HCV co-infection.
journal_name
HIV Medjournal_title
HIV medicineauthors
Cooper CL,Breau C,Laroche A,Lee C,Garber Gdoi
10.1111/j.1468-1293.2005.00340.xkeywords:
subject
Has Abstractpub_date
2006-01-01 00:00:00pages
32-7issue
1eissn
1464-2662issn
1468-1293pii
HIV340journal_volume
7pub_type
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