Our observation of a decline in the incidence of hepatotoxic events over the years suggests that a cumulative
toxic effect is unlikely. The representativeness of our study population for all NNRTI-using patients might be a point of discussion. After all, patients who develop (severe) toxicity in the first 3 years of therapy are less likely to continue using NNRTIs. learn more However, our short-term outcomes did not differ significantly from those reported by Brück et al.  and Palmon et al. . In those cohorts of all patients starting an NNRTI-based regimen, severe toxicity rates of 1.7% and 1.1%, respectively, were observed, compared with 1.4% in the first year in our cohort. Regarding moderate hepatotoxicity, the incidence in our group was actually slightly higher than the incidence reported by Brück et al. (4.9% vs. 3.1%, respectively). Because of the retrospective design of the study, we were not always able to obtain complete biochemical data and information regarding the use of other potentially hepatotoxic medication (e.g. prescribed by
buy LBH589 the patient’s general practitioner or over-the-counter drugs) and excessive alcohol use. We also cannot exclude the possibility that some of the LEEs were side effects of the nucleoside reverse transcriptase inhibitor (NRTI) backbone. The number of patients with an HBV or HCV coinfection was low; this raises the question of whether our results would have been the same if this group had been larger. In summary, long-term NNRTI use was not associated
with a higher risk of clinically significant liver toxicity in our group of patients who had not discontinued their therapy within the first 3 years of treatment. There does not seem to be a long-term cumulative hepatotoxic effect of these antiretrovirals. “
“Objectives The aim of the study was to evaluate the possible effect of hepatitis C virus (HCV) coinfection on the viroimmunological outcomes of HIV-1 infection. Methods A cross-sectional study of 805 patients with active HCV infection receiving or not receiving antiretroviral therapy (ART) was carried out. Results A number of parameters were significantly associated with undetectable HIV-1 viral load in univariate analyses, Amisulpride such as age, toxic habits, CD4 cell count, liver test results, HCV viral load and ART. However, only current ART (P<0.0001), CD4 cell count (P<0.0001), age (P=0.004) and current injecting drug use (P=0.02) were independently associated with undetectable viral load in multivariate analysis. None of the many HCV- and liver fibrosis-related parameters analysed showed a significant association with HIV-1 viral load or CD4 cell count in multivariate analyses, with the exception of the annual fibrosis progression index which almost reached statistical significance in the subgroup of ART-untreated patients (P=0.06) and was inversely predictive of CD4 cell count in the whole group (P=0.007).