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Raltegravir-based therapy in a cohort of HIV/HCV co-infected individuals

Taramasso, Lucia and Madeddu, Giordano and Ricci, Elena and De Socio, Giuseppe Vittorio Luigi and Menzaghi, Barbara and Orofino, Giancarlo and Passerini, Simone and Franzetti, Marco and Maggi, Paolo and Dentone, Chiara and Martinelli, Canio and Celesia, Benedetto Maurizio and Penco, Giovanni and Libertone, Raffaella and Quirino, Tiziana and Bonfanti, Paolo and Di Biagio, Antonio (2015) Raltegravir-based therapy in a cohort of HIV/HCV co-infected individuals. Biomedicine & Pharmacotherapy, Vol. 69 , p. 233-236. Article.

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DOI: 10.1016/j.biopha.2014.12.006

Abstract

The relationship between hepatic tolerance and hepatitis C virus (HCV) co-infection has not been extensively studied in clinical practice. We assessed the efficacy and safety of raltegravir-based therapy in an Italian cohort of HIV/HCV co-infected patients. One hundred and forty patients with HIV/HCV co-infection initiating raltegravir from SCOLTA project (Surveillance Cohort Long-Term Toxicity Antiretrovirals) were examined. Of them, 43 were women, with mean age of 45.4 ± 6.4 years; 65 (46%) had undetectable HIV-RNA < 50 copies/mL and 75 (54%) HIV-RNA ≥ 50 copies/mL. According to CDC classification, 49 (35%) were in stage C. Based on Fib4 score at the time of starting raltegravir, patients were classified in class I in 41 cases, class II in 68 and in class III in 31 cases. Globally, the Fib4 score slightly decreased during 24 months follow-up, from 2.2 to a value of 1.8. Hepatic adverse events of any grade were observed in 67 patients, of which only 2 cases (3%) had severe liver toxicity (grade 3–4). Only one patient had to discontinue the therapy because of adverse events. According to univariate analysis, being in CDC stage C represented a risk for the development of liver toxicity, with a hazard ratio (HR) of 2.27 (95% CI 1.06–4.84, P = 0.033). None of the other variables considered (age, sex, years since detection of HIV and HCV-RNA detectable, years of previous HIV therapy, concomitant therapy with PI or NRTI, CD4+ cell count, Fib4, and transaminases level at baseline) resulted statistically correlated to the outcome. In conclusion, raltegravir-based regimens can be safely used in HCV infected patients; in this study, the hepatic toxicity has been found to be more frequent in patients with an advanced HIV disease (CDC stage C), independently of HIV-RNA suppression at raltegravir initiation.

Item Type:Article
ID Code:10618
Status:Published
Refereed:Yes
Uncontrolled Keywords:Raltegravir, hepatitis, HCV, tolerability, safety, efficacy
Subjects:Area 06 - Scienze mediche > MED/17 Malattie infettive
Deposited On:14 Jan 2015 15:43

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