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  4. Risk of elevation of serum creatine kinase among HIV-positive individuals receiving dolutegravir-based combination antiretroviral therapy
 
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Risk of elevation of serum creatine kinase among HIV-positive individuals receiving dolutegravir-based combination antiretroviral therapy

Journal
Medicine
Journal Volume
98
Journal Issue
26
Pages
e16235
Date Issued
2019
Author(s)
Chen G.-J.
HSIN-YUN SUN  
ARISTINE CHENG  
YU-CHUNG CHUANG  
YU-SHAN HUANG  
KUAN-YIN LIN  
YI-CHIA HUANG  
Liu W.-C.
Wu P.-Y.
CHIEN-CHING HUNG  
SHAN-CHWEN CHANG  
DOI
10.1097/MD.0000000000016235
URI
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85069261388&doi=10.1097%2fMD.0000000000016235&partnerID=40&md5=648ef9d0446dd55833da5c73aa712dbb
https://scholars.lib.ntu.edu.tw/handle/123456789/535210
Abstract
We aimed to compare the risks of creatine kinase (CK) elevation between patients receiving dolutegravir-based antiretroviral therapy (ART) and those receiving non-integrase strand transfer inhibitor (InSTI)-based ART. HIV-positive patients seeking HIV outpatient care between February 2017 and March 2018 were retrospectively reviewed to collect information on ART, practices of vigorous exercise, and laboratory tests including CK level, plasma HIV RNA load, and concurrent medications. The incidences of CK elevation were estimated among patients receiving dolutegravir-based ART and those receiving non-InSTI-based ART. During the 14-month study period, 1406 patients (mean age 39.4 years and 96.9% being male) were included. The incidence rate of grade 3 or grade 4 CK elevation (>10-fold of the upper limit of normal) was 2.0 per 100 person-years of follow-up (PYFU) and 1.3 per 100 PYFU in the dolutegravir and non-InSTI group, respectively (P = .32). While dolutegravir group had a higher rate of CK elevation of any level than non-InSTI group (22.9 vs 17.4 per 100 PYFU, P = .01), the risk was associated with weight (adjusted odds ratio [aOR], per 10-kg increase, 1.03; 95% CI, 1.02–1.04), duration of exercise (aOR, per 1-hour increase, 1.02; 95% CI 1.01–1.03), but not with dolutegravir-based ART (aOR, 1.00; 95% CI, 0.99–1.06) after adjusting for the testing frequency of serum CK in the multivariate generalized estimating equation model. No patients were hospitalized or switched ART due to CK elevation. Serum CK elevation was associated with weight and duration of exercise among HIV-positive patients receiving ART, but not with dolutegravir-based ART. Copyright ? 2019 the Author(s). Published by Wolters Kluwer Health, Inc.
SDGs

[SDGs]SDG3

Other Subjects
antiretrovirus agent; creatine kinase; dolutegravir; fused heterocyclic rings; integrase inhibitor; adult; blood; cohort analysis; comparative study; drug combination; female; human; Human immunodeficiency virus infection; male; retrospective study; risk factor; Adult; Anti-Retroviral Agents; Cohort Studies; Creatine Kinase; Drug Combinations; Female; Heterocyclic Compounds, 3-Ring; HIV Integrase Inhibitors; HIV Seropositivity; Humans; Male; Retrospective Studies; Risk Factors
Publisher
NLM (Medline)
Type
journal article

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