Risk factors for hepatotoxicity in HIV-1-infected patients receiving ritonavir and saquinavir with or without stavudine

E. H. Gisolf, C. Dreezen, S. A. Danner, J. L.F. Weel, G. J. Weverling, P. Reiss, G. J. Weverling, M. Duurvoort, E. Krijger, E. Brouwer, G. R. Visser, A. Klotz, C. Benschop, F. Wulfert, S. A. Danner, F. De Wolf, S. Jurriaans, P. Portegies, R. Colebunders, J. PelgromH. Wijnants, A. DE Roo, K. Keersmaekers, M. Vandenbruane, D. Van Den Branden, T. James, F. Van Wanzeele, B. Van Der Gucht, M. E. Van Der Ende, J. Nouwen, R. Deenenkamp, D. Van Der Meyden, P. P. Koopmans, K. Brinkman, H. Ver Hofstede, B. Zomer, W. L. Blok, C. Ruissen, H. Sprenger, G. Law, P. Vander Meulen, C. Ten Veen, J. R. Juttmann, C. Vander Heul, R. Santegoets, B. Vander Ven, R. W.Ten Kate, M. Schoemaker, R. H. Kauffmann, J. M. Henrichs, A. Maat, E. Prins, C. H.H.Ten Napel, K. Pogany, T. Duyts, P. Simons, P. Lacor, A. De Waele, E. Van Wijngaarden, M. Lejeune, E. Van Wijngaarden, M. Lejeune, P. Nieuwkerk, M. Sprangers, M. Roos, R. Scholte, J. Dijkman, A. J. Japour, M. J. Borst, E. Van Leeuwen

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Liver enzyme elevation (LEE) is commonly observed after combination antiretroviral therapy (ARVT) for HIV infection is begun. Potential risk factors for LEE after treatment with ritonavir and saquinavir with or without stavudine were investigated in 208 HIV-infected patients, by use of the Cox proportional hazard model. Eighteen patients (9%) developed LEE during the 48-week follow-up. Multivariate analysis, adjusted for baseline levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST), showed that hepatitis B surface antigen (HBsAg) positivity (relative risk [RR], 8.8; 95% confidence interval [CI], 3.3-23.1) and the use of stavudine (RR, 4.9; 95% CI, 1.5-16.0) were the only significant risk factors for developing LEE. After LEE occurred, ALT and AST concentrations decreased by >50% in 13 of 14 patients who continued ARVT during LEE. In this study, it appeared safe to continue ARVT during LEE; however, more data from larger studies are required to confirm this finding.

Original languageEnglish
Pages (from-to)1234-1239
Number of pages6
JournalClinical Infectious Diseases
Issue number5
Publication statusPublished - 2000

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