The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of any of the funding agencies, including the Department of Veterans Affairs or the United States government. The funding agencies had no further role in study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the paper for publication.
Hepatic Safety and Antiretroviral Effectiveness in HIV-Infected Patients Receiving Naltrexone
Article first published online: 28 JUL 2011
Copyright © 2011 by the Research Society on Alcoholism
Alcoholism: Clinical and Experimental Research
Volume 36, Issue 2, pages 318–324, February 2012
How to Cite
Tetrault, J. M., Tate, J. P., McGinnis, K. A., Goulet, J. L., Sullivan, L. E., Bryant, K., Justice, A. C., Fiellin, D. A. and For the Veterans Aging Cohort Study Team (2012), Hepatic Safety and Antiretroviral Effectiveness in HIV-Infected Patients Receiving Naltrexone. Alcoholism: Clinical and Experimental Research, 36: 318–324. doi: 10.1111/j.1530-0277.2011.01601.x
- Issue published online: 27 JAN 2012
- Article first published online: 28 JUL 2011
- Received for publication February 9, 2011; accepted May 16, 2011.
- Opioid-Related Disorders
Background: We sought to determine the impact of naltrexone on hepatic enzymes and HIV biomarkers in HIV-infected patients.
Methods: We used data from the Veterans Aging Cohort Study-Virtual Cohort, an electronic database of administrative, pharmacy, and laboratory data. We restricted our sample to HIV-infected patients who received an initial oral naltrexone prescription of at least 7 days duration. We examined aspartate aminotransferase (AST) and alanine aminotransferase (ALT) and HIV biomarker (CD4 and HIV RNA) values for the 365 days prior to, during, and for the 365 days post-naltrexone prescription. We also examined cases of liver enzyme elevation (LEE; defined as >5 times baseline ALT or AST or >3.5 times baseline if baseline ALT or AST was >40 IU/l).
Results: Of 114 HIV-infected individuals, 97% were men, 45% white, 57% Hepatitis C co-infected; median age was 49 years; 89% of the sample had a history of alcohol dependence and 32% had opioid dependence. Median duration of naltrexone prescription was 49 (interquartile range 30 to 83) days, representing 9,525 person-days of naltrexone use. Mean ALT and AST levels remained below the upper limit of normal. Two cases of LEE occurred. Mean CD4 count remained stable and mean HIV RNA decreased after naltrexone prescription.
Conclusions: In HIV-infected patients, oral naltrexone is rarely associated with clinically significant ALT or AST changes and does not have a negative impact on biologic parameters. Therefore, HIV-infected patients with alcohol or opioid dependence can be treated with naltrexone.