scholarly journals Risk Factors Associated with Chronic Liver Enzyme Elevation (cLEE) in Persons Living with HIV without Hepatitis B or C co-infection in the Combination Antiretroviral Therapy Era

2021 ◽  
Author(s):  
Shannon Wood ◽  
Seung Hyun Won ◽  
Hsing-Chuan Hsieh ◽  
Tahaniyat Lalani ◽  
Karl Kronmann ◽  
...  
Keyword(s):  
Risk Factors ◽  
Antiretroviral Therapy ◽  
Liver Enzyme ◽  
Cox Proportional Hazards ◽  
Chronic Liver ◽  
Combination Antiretroviral Therapy ◽  
Liver Enzyme Elevation ◽  
Factors Associated ◽  
Persons Living With Hiv ◽  
Enzyme Elevation

Abstract Background As morbidity due to viral co-infections declines among HIV-infected persons, changes in liver related morbidity are anticipated. We examined data from the US Military HIV Natural History Study (NHS), a cohort of military beneficiaries, to evaluate incidence and risk factors associated with chronic liver enzyme elevation (cLEE) in HIV mono-infected patients in the combination antiretroviral therapy (cART) era. Methods Participants who were HBV and HCV seronegative with follow-up after 1996 were included. We defined chronic liver enzyme elevation (cLEE) as alanine aminotransferase (ALT) elevations ≥ 1.25 times the upper limit of normal on at least two visits, for a duration of six months or more within 2 years. We used multivariate Cox proportional hazards models to examine risk factors for cLEE. Results Of 2,779 participants, 309 (11%) met criteria for cLEE for an incidence of 1.28/100 PYFU (1.28 – 1.29). In an adjusted model, cLEE was associated with Hispanic/other ethnicity [Reference Caucasian: HR 1.744 (1.270 – 2.395)], non–nucleoside reverse transcriptase (NNRTI) based cART [Reference boosted protease inhibitors: HR 2.232 (1.378 – 3.616)], being cART naïve [HR 6.046 (3.686 – 9.915)] or having cART interruptions [HR 8.671 (4.651 – 16.164)]. African American race [HR 0.669 (0.510 – 0.877)] and integrase strand transfer inhibitor (INSTI) based cART [HR 0.222 (0.104 – 0.474)] were protective. Conclusions Our findings demonstrate initiation and continued use of cART is protective against cLEE and supports the hypothesis HIV infection directly impacts the liver. INSTI based regimens were protective and could be considered in persons with cLEE.

scholarly journals The Incidence and Risk Factors Associated with Chronic Liver Enzyme Elevation (cLEE) in HIV-Monoinfected Persons

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S220-S221
Author(s):  
Shannon Wood ◽  
Morgan Byrne ◽  
Robert Deiss ◽  
Jason Okulicz ◽  
Thomas O’Bryan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Enzyme ◽  
Chronic Liver ◽  
Liver Enzyme Elevation ◽  
Factors Associated ◽  
Enzyme Elevation

scholarly journals Lopinavir/ritonavir treatment in HIV antiretroviral-experienced patients: evaluation of risk factors for liver enzyme elevation

HIV Medicine ◽  
2004 ◽  
Vol 5 (5) ◽  
pp. 334-343 ◽  
Author(s):  
P Meraviglia ◽  
M Schiavini ◽  
A Castagna ◽  
P Vigano ◽  
T Bini ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Enzyme ◽  
Liver Enzyme Elevation ◽  
Enzyme Elevation

scholarly journals Antiretroviral Drugs and Risk of Chronic Alanine Aminotransferase Elevation in Human Immunodeficiency Virus (HIV)-Monoinfected Persons: The Data Collection on Adverse Events of Anti-HIV Drugs Study

2016 ◽  
Vol 3 (1) ◽  
Author(s):  
Helen Kovari ◽  
Caroline A. Sabin ◽  
Bruno Ledergerber ◽  
Lene Ryom ◽  
Peter Reiss ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Liver Enzyme ◽  
Chronic Liver ◽  
Liver Enzyme Elevation ◽  
Immunodeficiency Virus ◽  
Short And Long Term ◽  
Enzyme Elevation ◽  
Hiv Drugs ◽  
Anti Hiv

Abstract Background.  Although human immunodeficiency virus (HIV)-positive persons on antiretroviral therapy (ART) frequently have chronic liver enzyme elevation (cLEE), the underlying cause is often unclear. Methods.  Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) Study participants without chronic viral hepatitis were observed to the earliest of cLEE (elevated aminotransferase ≥6 months), death, last follow-up, or January 2, 2014. Antiretroviral treatment exposure was categorized as follows: no exposure and ongoing short- and long-term exposure (<2 or ≥2 years) after initiation. Association between development of cLEE and ART exposure was investigated using Poisson regression. Results.  Among 21 485 participants observed for 105 413 person-years (PY), 6368 developed cLEE (incidence 6.04/100 PY; 95% confidence interval [CI], 5.89–6.19). Chronic liver enzyme elevation was associated with short-and long-term exposure to didanosine (<2 years rate ratio [RR] = 1.29, 95% CI, 1.11–1.49; >2 years RR = 1.26, 95% CI, 1.13–1.41); stavudine (<2 years RR = 1.51, 95% CI, 1.26–1.81; >2 years RR = 1.17, 95% CI, 1.03–1.32), and tenofovir disoproxil fumarate (<2 years RR = 1.55, 95% CI, 1.40–1.72; >2 years RR = 1.18, 95% CI, 1.05–1.32), but only short-term exposure to nevirapine (<2 years RR = 1.44, 95% CI, 1.29–1.61), efavirenz (<2 years RR = 1.14, 95% CI, 1.03–1.26), emtricitabine (<2 years RR = 1.18, 95% CI, 1.04–1.33), and atazanavir (<2 years RR = 1.20, 95% CI, 1.04–1.38). Chronic liver enzyme elevation was not associated with use of lamivudine, abacavir, and other protease inhibitors. Mortality did not differ between participants with and without cLEE. Conclusions.  Although didanosine, stavudine, nevirapine, and efavirenz have been described to be hepatotoxic, we additionally observed a consistent association between tenofovir and cLEE emerging within the first 2 years after drug initiation. This novel tenofovir-cLEE signal should be further investigated.

An assessment of factors associated with neurocognitive decline in people living with HIV

2021 ◽  
pp. 095646242110433
Author(s):  
Zaeema Naveed ◽  
Howard S Fox ◽  
Christopher S Wichman ◽  
Pamela May ◽  
Christine M Arcari ◽  
...  
Keyword(s):  
Risk Factors ◽  
Antiretroviral Therapy ◽  
Cox Proportional Hazards ◽  
Health Concern ◽  
People Living With Hiv ◽  
Hepatitis C Infection ◽  
Factors Associated ◽  
History Of ◽  
Living With Hiv ◽  
Neurocognitive Decline

Despite the widespread use of combination antiretroviral therapy (cART), HIV-associated neurocognitive impairment (NCI) remains a health concern. However, limited research has been done to identify factors associated with neurocognitive decline. We assessed risk factors associated with neurocognitive decline in people living with HIV using a definition of decline that is statistically easy to adopt, is based on a commonly used neuropsychological cut-off and may be clinically relevant. Cox proportional hazards modeling was performed using the CNS HIV Antiretroviral Therapy Effects Research (CHARTER) study database. 581 participants were followed for up to 12 years. Neurocognitive decline was defined as the first observed drop in global T-scores of at least 2.67. Lifetime methamphetamine use had the strongest association with neurocognitive decline (adjusted Hazard Ratio; aHR = 1.48; 95% CI = 0.92–2.39) followed by no current antiretroviral medication use (aHR = 1.32; 95% CI = 0.91–1.92). Other risk factors included Hispanic ethnicity, lifetime history of major depressive disorder, lifetime cannabis use, hepatitis-C infection, and difficulty eating, dressing, bathing, or using the toilet. Results indicate that consistent use of ART may be of high significance to preserving neurocognition. Furthermore, Hispanic patients, those with a history of depression and substance use, and those having difficulty in essential activities of daily living may require vigilant follow-up.

scholarly journals Hepatotoxicity in HIV-infected children and adolescents on antiretroviral therapy

2007 ◽  
Vol 125 (4) ◽  
pp. 205-209 ◽  
Author(s):  
Ana Cecília Montes Gil ◽  
Raquel Lorenzetti ◽  
Gun Bergsten Mendes ◽  
André Moreno Morcillo ◽  
Adyléia Aparecida Dalbo Contrera Toro ◽  
...  
Keyword(s):  
Risk Factors ◽  
Antiretroviral Therapy ◽  
Children And Adolescents ◽  
Liver Enzyme ◽  
Serum Levels ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Odds Ratios ◽  
Cross Sectional ◽  
Enzyme Elevation

CONTEXT AND OBJECTIVE: Adverse drug reactions are a significant problem in patients on antiretroviral therapy (ART). We determined liver enzyme elevation frequencies in HIV-infected children and adolescents receiving ART, and their association with risk factors. DESIGN AND SETTING: Cross-sectional study, at the Pediatrics Immunodeficiency Division, University Hospital, Universidade Estadual de Campinas. METHODS: Medical records of 152 children and adolescents (54.6% male; median age 7.48 years) were analyzed, with a mean of 2.6 liver enzyme determinations per patient. Clinically, patients were classified in categories N (6), A (29), B (78) and C (39). Serum levels of aspartate aminotransferase and alanine aminotransferase were evaluated. Hepatotoxicity was scored as grade 1 (1.1-4.9 times upper limit of normality, ULN), grade 2 (5.0-9.9 times ULN), grade 3 (10.0-15.0 times ULN) and grade 4 (> 15.0 times ULN). To assess hepatotoxicity risk factors, odds ratios (OR) and adjusted odds ratios (aOR) for age, gender, TCD4+ cell count, viral load and medication usage were calculated. RESULTS: We observed grade 1 hepatotoxicity in 19.7 % (30/152) patients. No cases of grade 2, 3 or 4 were detected. There was a significant association between hepatotoxicity and use of sulfonamides (OR, 3.61; 95% confidence interval (CI), 1.50-8.70; aOR, 3.58; 95% CI, 1.44-8.85) and antituberculous agents (OR, 9.23; 95% CI, 1.60-53.08; aOR, 9.05; 95% CI, 1.48-55.25). No toxicity was associated with ART. CONCLUSIONS: One fifth of patients experienced mild hepatotoxicity, attributed to antituberculous agents and sulfonamides. Our results suggest that ART was well tolerated.

scholarly journals Risk Factors for Postoperative Liver Enzyme Elevation After Laparoscopic Gastrectomy for Gastric Cancer

In Vivo ◽  
2021 ◽  
Vol 35 (2) ◽  
pp. 1227-1234
Author(s):  
AKIHIKO SANO ◽  
KANA SAITO ◽  
KENGO KURIYAMA ◽  
NOBUHIRO NAKAZAWA ◽  
YASUNARI UBUKATA ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Liver Enzyme ◽  
Laparoscopic Gastrectomy ◽  
Liver Enzyme Elevation ◽  
Enzyme Elevation
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