A switch to Raltegravir improves antiretroviral associated hepatotoxicity in individuals co-infected with HIV and hepatitis C

作者：Cevik M^*; Katsarolis I; Singh G J; Nelson M

来源：Journal of Infection, 2014, 69(2): 190-193.

DOI：10.1016/j.jinf.2014.04.005

• HIV
• Hepatitis
• Hepatitis C
• Raltegravir
• cART
• Hepatotoxicity
• Liver
• Enzyme elevations
• Co-infection

Introduction: Raltegravir is a switch option for HIV/HCV co-infected individuals due to its hepatic neutral profile. We evaluated the effect of a switch to Raltegravir from other antiretroviral agents in HIV and HCV-co-infected individuals naive to HCV therapy.
Methods: Observational, single-centre study. Data on alanine aminotransferase levels, HCV-VL, CD4 cell count, HIV viral load levels and hepatic fibrosis score were collated six months pre-switch, at the time of switch and six months post switch to Raltegravir therapy.
Results were compared utilizing the Kruskale-Wallis test. Results: Twenty-seven individuals were identified. Median age was 43 years, median duration of HIV infection was 7 years and median documented period of HCV infection at the time of switch was 26 months. A sustained improvement in ALT levels was observed. Median ALT levels were 254 IU/L at the time of switch, decreasing significantly to 176 IU/L, (p = 0.0226) and 90 IU/L (p = 0.0138) 1 month post switch and 6 months post switch respectively. The median Hepatitis C viral load level at the time of the switch was 341,783 copies/mL, which decreased to 224,066 copies/mL 6 months after switch (p = 0.04).
Discussion: A switch to Raltegravir in individuals with HIV/HCV co-infection was effective in maintaining HIV virological suppression with improvement in drug-associated hepatotoxicity as measured by ALT.

• 出版日期2014-8