Incidence and risk factors of skin rashes and hepatotoxicity in HIV-infected patients receiving nevirapine-containing combination antiretroviral therapy in Taiwan
Journal
International Journal of Infectious Diseases
Journal Volume
29
Pages
12-17
Date Issued
2014
Author(s)
Tseng Y.-T.
Yang C.-J.
Tsai M.-S.
Liu W.-C.
Wu P.-Y.
Su Y.-C.
Luo Y.-Z.
Yang S.-P.
Abstract
Objectives: To retrospectively investigate the incidence of and factors associated with skin rashes and hepatotoxicity in HIV-infected patients who initiated combination antiretroviral therapy (cART) containing nevirapine plus two nucleos(t)ide reverse-transcriptase inhibitors. Methods: The medical records of HIV-infected adult patients who started nevirapine-containing cART and continued follow-up for ?4 weeks were reviewed at two hospitals in Taiwan between 2000 and 2012. Clinical data obtained at baseline and during follow-up were collected and analyzed. Results: Of the 338 patients included in the analysis, 13.0% tested positive for hepatitis B virus surface antigen and 7.9% tested positive for anti-hepatitis C virus antibody. The incidence of rashes was 21.6% and of hepatotoxicity was 25.5%. On multiple logistic regression analysis, a two-fold or greater increase from the upper limit of normal levels of aminotransferases at baseline was associated with rashes (adjusted odds ratio (aOR) 3.74, 95% confidence interval (CI) 1.56-8.96); higher CD4 counts (aOR for per 50 cells/μl increase 1.51, 95% CI 1.12-2.03) and the concurrent use of trimethoprim/sulfamethoxazole (aOR 14.01, 95% CI 1.98-98.95) were associated with hepatotoxicity. Conclusions: Abnormal liver function at baseline was significantly associated with skin rashes, while a higher CD4 count and the concurrent use of trimethoprim/sulfamethoxazole were associated with hepatotoxicity after the initiation of nevirapine-containing cART in HIV-infected Taiwanese patients. ? 2014 The Authors.
SDGs
Other Subjects
abacavir; aminotransferase; cotrimoxazole; efavirenz; hepatitis B surface antigen; hepatitis C antibody; indinavir; nelfinavir; nevirapine; ritonavir; RNA directed DNA polymerase inhibitor; saquinavir; tuberculostatic agent; virus RNA; anti human immunodeficiency virus agent; hepatitis C antibody; nevirapine; RNA directed DNA polymerase inhibitor; adult; Article; CD4 lymphocyte count; drug eruption; drug substitution; drug treatment failure; drug withdrawal; female; follow up; hepatitis B; hepatitis C; highly active antiretroviral therapy; human; Human immunodeficiency virus infected patient; Human immunodeficiency virus infection; hyperlipidemia; kidney colic; lipodystrophy; liver function; major clinical study; male; mental disease; mixed infection; risk factor; seroprevalence; Taiwan; Taiwanese; toxic hepatitis; virus load; complication; drug combination; drug effects; Exanthema; HIV Infections; incidence; liver; middle aged; retrospective study; Adult; Anti-HIV Agents; Drug Therapy, Combination; Exanthema; Female; Hepatitis C Antibodies; HIV Infections; Humans; Incidence; Liver; Male; Middle Aged; Nevirapine; Retrospective Studies; Reverse Transcriptase Inhibitors; Risk Factors; Taiwan
Type
journal article