Liver tolerance of raltegravir-containing antiretroviral therapy in HIV-infected patients with chronic hepatitis C
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2025
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| author | Macías J Neukam K Portilla J Iribarren JA de los Santos I Rivero A Márquez M Delgado M Téllez F Merino D Giner L Von Wichmann MA Pineda JA Herpal Study team |
| author_facet | Macías J Neukam K Portilla J Iribarren JA de los Santos I Rivero A Márquez M Delgado M Téllez F Merino D Giner L Von Wichmann MA Pineda JA Herpal Study team |
| contents | <p><strong>Objectives: </strong>To evaluate the liver safety of raltegravir-including combinations in HIV/hepatitis C virus (HCV) co-infected patients.</p> <p><strong>Methods: </strong>Grade 3-4 transaminase elevations (TEs) and grade 4 total bilirubin elevations (TBEs) were assessed during 12 months in 108 HIV/HCV co-infected patients starting antiretroviral therapy including raltegravir in a retrospective cohort study. Furthermore, the relationship between baseline fibrosis and hepatotoxic events was determined.</p> <p><strong>Results: </strong>Eight patients (7.4%) developed grade 3 TEs and two (1.9%) patients showed grade 4 TEs. TBE grade 4 was detected in two (1.9%) patients. No patient permanently discontinued raltegravir because of hepatotoxic events. Of the patients with and without significant fibrosis, six (9.4%) and two (11.8%), respectively, showed grade 3-4 TEs (P = 0.769). Grade 3-4 TEs was observed in four (9.8%) patients in whom cirrhosis was ruled out, while none of the patients diagnosed with cirrhosis developed grade 3-4 TEs (P = 0.303). During the follow-up, the median (Q1-Q3) CD4 cell count increased from 257 (145-421) cells/mm(3) to 407 (213-587) cells/mm(3) (P < 0.0001) and the number of patients with an undetectable HIV viral load augmented from 33 (30.6%) to 73 (81.1%) (P = 0.002).</p> <p><strong>Conclusions: </strong>Raltegravir-containing regimens are safe in HIV/HCV co-infected patients. The incidence of severe liver toxicity of raltegravir in these individuals is in the range of boosted protease inhibitors in clinical trials. The frequencies of grade 3-4 TEs and grade 4 TBEs were similar in patients receiving raltegravir with or without significant fibrosis or cirrhosis.</p> |
| format | Recurso digital |
| id | zenodo_https___doi_org_10_1093_jac_dkr083 |
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| publishDate | 2025 |
| publisher | Zenodo |
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| spellingShingle | Liver tolerance of raltegravir-containing antiretroviral therapy in HIV-infected patients with chronic hepatitis C Macías J Neukam K Portilla J Iribarren JA de los Santos I Rivero A Márquez M Delgado M Téllez F Merino D Giner L Von Wichmann MA Pineda JA Herpal Study team <p><strong>Objectives: </strong>To evaluate the liver safety of raltegravir-including combinations in HIV/hepatitis C virus (HCV) co-infected patients.</p> <p><strong>Methods: </strong>Grade 3-4 transaminase elevations (TEs) and grade 4 total bilirubin elevations (TBEs) were assessed during 12 months in 108 HIV/HCV co-infected patients starting antiretroviral therapy including raltegravir in a retrospective cohort study. Furthermore, the relationship between baseline fibrosis and hepatotoxic events was determined.</p> <p><strong>Results: </strong>Eight patients (7.4%) developed grade 3 TEs and two (1.9%) patients showed grade 4 TEs. TBE grade 4 was detected in two (1.9%) patients. No patient permanently discontinued raltegravir because of hepatotoxic events. Of the patients with and without significant fibrosis, six (9.4%) and two (11.8%), respectively, showed grade 3-4 TEs (P = 0.769). Grade 3-4 TEs was observed in four (9.8%) patients in whom cirrhosis was ruled out, while none of the patients diagnosed with cirrhosis developed grade 3-4 TEs (P = 0.303). During the follow-up, the median (Q1-Q3) CD4 cell count increased from 257 (145-421) cells/mm(3) to 407 (213-587) cells/mm(3) (P < 0.0001) and the number of patients with an undetectable HIV viral load augmented from 33 (30.6%) to 73 (81.1%) (P = 0.002).</p> <p><strong>Conclusions: </strong>Raltegravir-containing regimens are safe in HIV/HCV co-infected patients. The incidence of severe liver toxicity of raltegravir in these individuals is in the range of boosted protease inhibitors in clinical trials. The frequencies of grade 3-4 TEs and grade 4 TBEs were similar in patients receiving raltegravir with or without significant fibrosis or cirrhosis.</p> |
| title | Liver tolerance of raltegravir-containing antiretroviral therapy in HIV-infected patients with chronic hepatitis C |
| url | https://doi.org/10.1093/jac/dkr083 |