TY - JOUR
T1 - Hepatotoxicity during nevirapine-based fixed-dose combination antiretroviral therapy in Kampala, Uganda
AU - Hahn, Judith A.
AU - Maier, Marissa
AU - Byakika-Tusiime, Jayne
AU - Oyugi, Jessica H.
AU - Bangsberg, David R.
PY - 2007/6
Y1 - 2007/6
N2 - Background: Generic, low-cost, nevirapine (NVP)-based antiretroviral therapy (ART) has improved survival in HIV-infected individuals living in resource-limited settings. However, there is concern about the potential hepatotoxicity of these regimens. Methods: The authors conducted a prospective study of persons initiating self-pay Triomune or Maxivir therapy in Kampala, Uganda. Results: The 97 study participants were predominantly women (64%), median age was 35 (interquartile range [IQR] 30-40), median CD4 at baseline was 56 cells/mm 3 (IQR 8-138), and 19% had lifetime alcohol problems (CAGE < 2). Severe liver enzyme elevations (LEEs) of grade 3-4 were rare (2.2%); however, 1 patient died in the setting of grade 4 LEEs. Grade 1-4 LEEs occurred among 22.2% of participants, and 9.8% had new grade 1-4 LEEs after the initiation of treatment. Discussion: The authors found that LEEs were common but that severe hepatotoxicity in persons initiating NVP-based ART was infrequent yet potentially life-threatening. Monitoring for NVP-related severe hepatic toxicity should be part of expanding antiretroviral treatment programs in resource-limited settings.
AB - Background: Generic, low-cost, nevirapine (NVP)-based antiretroviral therapy (ART) has improved survival in HIV-infected individuals living in resource-limited settings. However, there is concern about the potential hepatotoxicity of these regimens. Methods: The authors conducted a prospective study of persons initiating self-pay Triomune or Maxivir therapy in Kampala, Uganda. Results: The 97 study participants were predominantly women (64%), median age was 35 (interquartile range [IQR] 30-40), median CD4 at baseline was 56 cells/mm 3 (IQR 8-138), and 19% had lifetime alcohol problems (CAGE < 2). Severe liver enzyme elevations (LEEs) of grade 3-4 were rare (2.2%); however, 1 patient died in the setting of grade 4 LEEs. Grade 1-4 LEEs occurred among 22.2% of participants, and 9.8% had new grade 1-4 LEEs after the initiation of treatment. Discussion: The authors found that LEEs were common but that severe hepatotoxicity in persons initiating NVP-based ART was infrequent yet potentially life-threatening. Monitoring for NVP-related severe hepatic toxicity should be part of expanding antiretroviral treatment programs in resource-limited settings.
KW - HIV
KW - Uganda
KW - antiretroviral therapy
KW - hepatotoxicity
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U2 - 10.1177/1545109707299356
DO - 10.1177/1545109707299356
M3 - Article
C2 - 17537997
AN - SCOPUS:35549000405
SN - 1545-1097
VL - 6
SP - 83
EP - 86
JO - Journal of the International Association of Physicians in AIDS Care
JF - Journal of the International Association of Physicians in AIDS Care
IS - 2
ER -