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Clinical outcomes of first antiretroviral regimen in HIV/hepatitis C virus co-infection

  1. CL Cooper,
  2. C Breau,
  3. A LaRoche,
  4. C Lee,
  5. G Garber

Article first published online: 24 NOV 2005

DOI: 10.1111/j.1468-1293.2005.00340.x

Issue

HIV Medicine

HIV Medicine

Volume 7, Issue 1, pages 32–37, January 2006

Additional Information

How to Cite

Cooper, C., Breau, C., LaRoche, A., Lee, C. and Garber, G. (2006), Clinical outcomes of first antiretroviral regimen in HIV/hepatitis C virus co-infection. HIV Medicine, 7: 32–37. doi: 10.1111/j.1468-1293.2005.00340.x

Author Information

  1. Division of Infectious Diseases, The Ottawa Hospital, University of Ottawa, Ottawa, Canada

* Curtis Cooper, University of Ottawa, Division of Infectious Diseases, The Ottawa Hospital, G12-501 Smyth Road, Ottawa, ON K1H 8L6, Canada. Tel: (613) 737 8924; fax: (613) 737 8164; e-mail: ccooper@ottawahospital.on.ca

Publication History

  1. Issue published online: 24 NOV 2005
  2. Article first published online: 24 NOV 2005
  3. Received: 1 February 2005, accepted 29 March 2005

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Keywords:

  • HAART;
  • HCV;
  • liver

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.

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