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Hepatitis B or C virus coinfection in and risks for transaminitis in human immunodeficiency virus - infected Thais on combined antiretroviral therapy

Chareeporn Akekawatchai
Chareeporn Akekawatchai
, 
Warisara Sretapunya
Warisara Sretapunya
, 
Duangnate Pipatsatitpong
Duangnate Pipatsatitpong
 e 
Tippawan Chuenchit
Tippawan Chuenchit
   | 31 gen 2017
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INFORMAZIONI SU QUESTO ARTICOLO
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Article Category: Brief communication (Original)
Pubblicato online: 31 gen 2017
Pagine: 353 - 361
DOI: https://doi.org/10.5372/1905-7415.0903.404
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© 2015 Chareeporn Akekawatchai, Warisara Sretapunya, Duangnate Pipatsatitpong, Tippawan Chuenchit
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Characteristics of patients infected with human immunodeficiency virus (HIV) recruited in this study

CharacteristicsAll HIV+ n(%)HBsAg-/ anti-HCV- n(%)HBsAg+/ anti-HCV- n(%)HBsAgV-/ anti-HCV+ n(%)P
Patients (%)211(100)171(81.0)24(11.4)16(7.6)
Age (years)
 <3034(16.1)31(18.1)3 (12.5)0(0.0)
 31–4082(38.9)62(36.3)12(50.0)8(50.0)
 41-5053(25.1)45(26.3)4(16.7)4(25.0)
 >5042(19.9)33(19.3)5 (20.8)4(25.0)0.41
Sex
  Male92(43.6)67(39.2)13 (54.2)12(75.0)
  Female119(56.4)104(60.8)11(45.8)4(25.0)0.013

P < 0.05. ARV = antiretroviral, BMI = body mass index, AST = aspartate aminotransferase, ALT = alanine aminotransferase. ULN = upper limit of normal, HBsAg = hepatitis B vims (HBV) surface antigen, HBeAg = extracellular form of HBV core antigen; HCV = hepatitis C virus

BMI(kg/m2)
 Normal143 (67.8)119(69.6)12(50.0)12(75.0)
 Underweight34(16.1)24(14.0)7(29.2)3 (18.8)
 Overweight/obese34(16.1)28(16.4)5 (20.8)1(6.3)0.21
Transmission routes
 Sex with a spouse133 (63.0)111(64.9)15(62.5)7(43.8)
 Sex with others59(28.0)45 (26.3)6(25.0)8(50.0)
 Men who have sex with men9(4.3)7(4.1)2(8.3)0(0.0)
 Others10(4.8)8(4.7)1(4.2)1(6.3)0.36
ARV drugs
 Naive to ARV treatment12(5.7)11(6.4)1(4.2)0(0.0)
 Lamivudine/stavudine/nevirapine23 (10.9)19(11.1)2(8.3)2(12.5)
 Lamivudine/zidovudine/nevirapine103 (48.8)86(50.3)10(41.7)7(43.8)
 Lopinavir/ritonavir or atazanavir24(11.4)17(9.9)3 (12.5)4 (25.0)
 Others49(23.2)38(22.2)8(33.3)3 (18.8)0.71
Duration of ARV treatment
 <3 months27(12.8)26(15.2)1(4.2)0(0)
 3-6 months7(3.3)7(4.1)0(0)0(0)
 >6 months177(83.9)138(80.7)23 (95.8)16(100)0.22
CD4+(cells/μL)
 <20053 (25.2)41 (24.0)9(37.5)3 (18.8)
 200–349.952(24.6)38(22.2)7(29.2)7(43.8)
 >350106(50.2)92(53.8)8(33.3)6(37.5)0.13
Transaminitis
 AST and/or ALT≤ULN (40 U/L)155 (73.5)136(79.5)16(66.7)3 (18.8)
 AST and/or ALT>ULN (40 U/L)56(26.5)35 (20.5)8(33.3)13(81.3)0.001

P < 0.05. ARV = antiretroviral, BMI = body mass index, AST = aspartate aminotransferase, ALT = alanine aminotransferase. ULN = upper limit of normal, HBsAg = hepatitis B vims (HBV) surface antigen, HBeAg = extracellular form of HBV core antigen; HCV = hepatitis C virus

Univariate and multivariate analysis of risks for the transaminitis in patients infected with human immunodeficiency vims (HIV) (n = 211 )

CharacteristicsEnrolled patientsPatients with transaminitis n(%)Crude OR (95%CI)PAdjusted OR (95%CI)P
Age (years)
 <30343(5)11
 31–408230(54)5.9(1.7-21.2)0.006

P < 0.05, OR = Odds ratio, CI = Confidence interval, HBsAg = HBV surface antigen, HCV = hepatitis C virus

4.6(1.2-17.5)0.023

P < 0.05, OR = Odds ratio, CI = Confidence interval, HBsAg = HBV surface antigen, HCV = hepatitis C virus

 41-505312(21)3.0(0.8-11.6)0.112.2(0.5-8.9)0.28
 >504211(20)3.7(0.9-14.4)0.062.6(0.6–10.9)0.20
Sex
 Male9236(64)11
 Female11920(36)0.3 (0.2–0.6)<0.001

P < 0.05, OR = Odds ratio, CI = Confidence interval, HBsAg = HBV surface antigen, HCV = hepatitis C virus

0.4(0.2-0.8)0.014

P < 0.05, OR = Odds ratio, CI = Confidence interval, HBsAg = HBV surface antigen, HCV = hepatitis C virus

CD4+(cells/μL)
 <2005320(36)11
 200–349.95218(32)0.9(0.4–1.9)0.740.9(0.4–2.4)0.91
 >35010618(32)0.3 (0.2–0.7)0.005

P < 0.05, OR = Odds ratio, CI = Confidence interval, HBsAg = HBV surface antigen, HCV = hepatitis C virus

0.4(0.2-0.9)0.04

P < 0.05, OR = Odds ratio, CI = Confidence interval, HBsAg = HBV surface antigen, HCV = hepatitis C virus

ARV treatment3(5)10.29
 Naive to ARV treatment1210(18)2.3 (0.5-10.8)0.65
 Lamivudine/stavudine/nevirapine2320(36)0.7(0.2-2.9)1.000
 Lamivudine/zidovudine/nevirapine1036(11)1.0(0.2–4.9)0.52
 Lopinavir/ritonavir or atazanavir2417(30)1.6(0.4–6.7)
 Others49
HBV and HCV serological status
 HBsAg– anti-HCV-17135(63)11
 HBsAg+anti-HCV-248(14)1.9(0.8–4.9)0.171.3(0.5-3.5)0.64
 HBsAg-anti-HCV+1613 (23)16.8(4.5–62.4)<0.001

P < 0.05, OR = Odds ratio, CI = Confidence interval, HBsAg = HBV surface antigen, HCV = hepatitis C virus

12.3(3.0–50.1)<0.001

P < 0.05, OR = Odds ratio, CI = Confidence interval, HBsAg = HBV surface antigen, HCV = hepatitis C virus

Medians of liver enzyme levels, AST and ALT, and CD4+ cell count in HIV monoinfected, and patients coinfected with HIV and HBV or HCV currently on combination ART (n= 199)

HBsAg-/anti-HCV- (n = 160)HBsAg/anti-HCV- (n = 23)HBsAg-/anti-HCV+ (n = 16)P
P
MedianRangeMedianRangeMedianRange
AST(U/L)23.0(9-1338)33.0

P < 0.05

(16-124)0.001*44.5

P < 0.001

(21-208)<0.001*
ALT(U/L)22.5(6-765)22.012-99)0.28051.5b(13-149)<0.001*
CD4+cells (cells/μL)388.5(4-1601)279.0(1-810)0.091311.0(1291238)0.46
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