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Antiretroviral drug-related liver mortality among HIV-positive persons in the absence of HBV or HCV co-infection. The Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) Study


Kovari, Helen; Sabin, Caroline A; Ledergerber, Bruno; Ryom, Lene; Worm, Signe W; Smith, Colette; Phillips, Andrew; Reiss, Peter; Fontas, Eric; Petoumenos, Kathy; De Wit, Stéphane; Morlat, Philippe; Lundgren, Jens D; Weber, Rainer (2013). Antiretroviral drug-related liver mortality among HIV-positive persons in the absence of HBV or HCV co-infection. The Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) Study. Clinical Infectious Diseases, 56(6):870-879.

Abstract

Background. Liver diseases are leading causes of death in HIV-positive persons since the widespread use of combination antiretroviral treatment (ART). Most of these deaths are due to hepatitis C (HCV) or B (HBV) virus co-infections. Little is known about other causes. Prolonged exposure to some antiretroviral drugs might increase hepatic mortality.Methods. All patients of the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study without HCV or HBV co-infection 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 co-infection for 114,478 person-years. There were 12 liver-related deaths (incidence, 0.10/1000 person-years); 7 because of severe alcohol use and 5 due to established ART-related toxicity. The rate of ART-related deaths in treatment-experienced persons was 0.04 (95% CI 0.01, 0.10) per 1000 person-years.Conclusions. We found a low incidence of liver-related deaths in HIV-infected persons without HCV or HBV co-infection. Liver-related mortality because of ART-related toxicity was rare.

Abstract

Background. Liver diseases are leading causes of death in HIV-positive persons since the widespread use of combination antiretroviral treatment (ART). Most of these deaths are due to hepatitis C (HCV) or B (HBV) virus co-infections. Little is known about other causes. Prolonged exposure to some antiretroviral drugs might increase hepatic mortality.Methods. All patients of the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study without HCV or HBV co-infection 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 co-infection for 114,478 person-years. There were 12 liver-related deaths (incidence, 0.10/1000 person-years); 7 because of severe alcohol use and 5 due to established ART-related toxicity. The rate of ART-related deaths in treatment-experienced persons was 0.04 (95% CI 0.01, 0.10) per 1000 person-years.Conclusions. We found a low incidence of liver-related deaths in HIV-infected persons without HCV or HBV co-infection. Liver-related mortality because of ART-related toxicity was rare.

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Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Infectious Diseases
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2013
Deposited On:14 Dec 2012 15:26
Last Modified:06 Aug 2017 20:12
Publisher:Oxford University Press
ISSN:1058-4838
Additional Information:This is a pre-copy-editing, author-produced PDF of an article accepted for publication in Clinical Infectious Diseases following peer review. The definitive publisher-authenticated version Kovari, Helen; Sabin, Caroline A; Ledergerber, Bruno; Ryom, Lene; Worm, Signe W; Smith, Colette; Phillips, Andrew; Reiss, Peter; Fontas, Eric; Petoumenos, Kathy; De Wit, Stéphane; Morlat, Philippe; Lundgren, Jens D; Weber, Rainer (2012). Antiretroviral drug-related liver mortality among HIV-positive persons in the absence of HBV or HCV co-infection. The Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) Study. Clinical Infectious Diseases:Epub ahead of print. is available online at: http://dx.doi.org/10.1093/cid/cis919.
Free access at:PubMed ID. An embargo period may apply.
Publisher DOI:https://doi.org/10.1093/cid/cis919
PubMed ID:23090925

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