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The effect of highly active antiretroviral therapy on liver function in human immunodeficiency virus-infected pediatric patients with or without hepatitis virus co-infection.

Wu L, Jin C, Bai S, Davies H, Rao H, Liang Y, Wu N - J Res Med Sci (2015)

Bottom Line: After HAART for 1-year, the median levels of viral load were decreased to lower limit of detection in 90.34% pediatric HIV-infected subjects with/without HBV/HCV co-infection (P < 0.001), and CD4(+) T-cell counts increased significantly (P < 0.001).Mean change values of ALT and AST were significantly higher in the NVP based regimen group than in the efavirenz (EFV) based regimen group (P < 0.01).For HIV/HBV/HCV co-infected patients, mean change values of ALT and AST in NVP-based HAART group was significantly higher than that in EFV-based HAART group (P < 0.01).

View Article: PubMed Central - PubMed

Affiliation: Department of Nursing, School of Medicine, Taizhou University, Taizhou 318000, China.

ABSTRACT

Background: Co-infection of hepatitis virus is common in human immunodeficiency virus (HIV) infected adults in China. But little is known about hepatitis virus co-infection in pediatric HIV-infected subjects. The study aimed to investigate the impact of hepatitis B virus (HBV) and/or hepatitis C virus (HCV) co-infection and highly active antiretroviral therapy (HAART) on liver function of pediatric HIV-infected subjects.

Materials and methods: A cohort study including 101 pediatric HIV-infected subjects with HBV/HCV co-infection and 44 pediatric comparators with HIV mono-infection was carried out in Henan Province of China from September 2011 to September 2012. All patients received HAART for 1-year. HBV and HCV infection was determined by antibody tests. HIV RNA load, CD4(+) T-cell counts and liver function were determined before and after HAART. The Student's t-test or a one-way ANOVA was used for normally distributed values and A Mann-Whitney U-test was performed for values without normal distribution using SPSS statistical package 18.0 (SPSS Inc.).

Results: After HAART for 1-year, the median levels of viral load were decreased to lower limit of detection in 90.34% pediatric HIV-infected subjects with/without HBV/HCV co-infection (P < 0.001), and CD4(+) T-cell counts increased significantly (P < 0.001). Compared with the pre-HAART, mean level of alanine aminotransferase (ALT) in each group had a significant increase after HAART (P < 0.01). The mean levels of ALT and aspartate aminotransferase (AST) in nevirapine (NVP) based HAART group increased significantly after HAART (P < 0.01). Mean change values of ALT and AST were significantly higher in the NVP based regimen group than in the efavirenz (EFV) based regimen group (P < 0.01). For HIV/HBV/HCV co-infected patients, mean change values of ALT and AST in NVP-based HAART group was significantly higher than that in EFV-based HAART group (P < 0.01).

Conclusion: Highly active antiretroviral therapy can damage liver function in pediatric HIV-infected subjects, especially in those with HBV/HCV co-infection. NVP was more harmful to liver function of pediatric HIV-infected subjects than EFV.

No MeSH data available.


Related in: MedlinePlus

The comparison of (a) alanine aminotransferase; (b) aspartate aminotransferase; and (c) total bilirubin in human immunodeficiency virus (HIV)/hepatitis B virus (HBV)/hepatitis C virus (HCV) co-infected group, HIV/HBV co-infected group, HIV/HCV co-infected group and HIV mono-infected group before and after highly active antiretroviral therapy (HAART). *P < 0.01, **P < 0.05, after HAART versus pre-HAART
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Figure 1: The comparison of (a) alanine aminotransferase; (b) aspartate aminotransferase; and (c) total bilirubin in human immunodeficiency virus (HIV)/hepatitis B virus (HBV)/hepatitis C virus (HCV) co-infected group, HIV/HBV co-infected group, HIV/HCV co-infected group and HIV mono-infected group before and after highly active antiretroviral therapy (HAART). *P < 0.01, **P < 0.05, after HAART versus pre-HAART

Mentions: In order to evaluate the change of the transaminase caused by HAART, ALT, AST, and total bilirubin in each of the four groups were analyzed. Compared with pre-HAART, the mean level of ALT in each group had a significant elevation after HAART (P < 0.01). Co-infection groups had a higher increase in ALT compared with HIV mono-infected group after HAART. Moreover, a remarkably higher ALT value was found in HIV/HCV co-infected group than HIV/HBV/HCV co-infected group (P < 0.05). The mean levels of AST and total bilirubin were also increased and much higher than pre-HAART in all the four groups after HAART, especially in HIV/HBV/HCV co-infected and HIV mono-infected group (P < 0.01 and P < 0.05) [Figure 1].


The effect of highly active antiretroviral therapy on liver function in human immunodeficiency virus-infected pediatric patients with or without hepatitis virus co-infection.

Wu L, Jin C, Bai S, Davies H, Rao H, Liang Y, Wu N - J Res Med Sci (2015)

The comparison of (a) alanine aminotransferase; (b) aspartate aminotransferase; and (c) total bilirubin in human immunodeficiency virus (HIV)/hepatitis B virus (HBV)/hepatitis C virus (HCV) co-infected group, HIV/HBV co-infected group, HIV/HCV co-infected group and HIV mono-infected group before and after highly active antiretroviral therapy (HAART). *P < 0.01, **P < 0.05, after HAART versus pre-HAART
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4400705&req=5

Figure 1: The comparison of (a) alanine aminotransferase; (b) aspartate aminotransferase; and (c) total bilirubin in human immunodeficiency virus (HIV)/hepatitis B virus (HBV)/hepatitis C virus (HCV) co-infected group, HIV/HBV co-infected group, HIV/HCV co-infected group and HIV mono-infected group before and after highly active antiretroviral therapy (HAART). *P < 0.01, **P < 0.05, after HAART versus pre-HAART
Mentions: In order to evaluate the change of the transaminase caused by HAART, ALT, AST, and total bilirubin in each of the four groups were analyzed. Compared with pre-HAART, the mean level of ALT in each group had a significant elevation after HAART (P < 0.01). Co-infection groups had a higher increase in ALT compared with HIV mono-infected group after HAART. Moreover, a remarkably higher ALT value was found in HIV/HCV co-infected group than HIV/HBV/HCV co-infected group (P < 0.05). The mean levels of AST and total bilirubin were also increased and much higher than pre-HAART in all the four groups after HAART, especially in HIV/HBV/HCV co-infected and HIV mono-infected group (P < 0.01 and P < 0.05) [Figure 1].

Bottom Line: After HAART for 1-year, the median levels of viral load were decreased to lower limit of detection in 90.34% pediatric HIV-infected subjects with/without HBV/HCV co-infection (P < 0.001), and CD4(+) T-cell counts increased significantly (P < 0.001).Mean change values of ALT and AST were significantly higher in the NVP based regimen group than in the efavirenz (EFV) based regimen group (P < 0.01).For HIV/HBV/HCV co-infected patients, mean change values of ALT and AST in NVP-based HAART group was significantly higher than that in EFV-based HAART group (P < 0.01).

View Article: PubMed Central - PubMed

Affiliation: Department of Nursing, School of Medicine, Taizhou University, Taizhou 318000, China.

ABSTRACT

Background: Co-infection of hepatitis virus is common in human immunodeficiency virus (HIV) infected adults in China. But little is known about hepatitis virus co-infection in pediatric HIV-infected subjects. The study aimed to investigate the impact of hepatitis B virus (HBV) and/or hepatitis C virus (HCV) co-infection and highly active antiretroviral therapy (HAART) on liver function of pediatric HIV-infected subjects.

Materials and methods: A cohort study including 101 pediatric HIV-infected subjects with HBV/HCV co-infection and 44 pediatric comparators with HIV mono-infection was carried out in Henan Province of China from September 2011 to September 2012. All patients received HAART for 1-year. HBV and HCV infection was determined by antibody tests. HIV RNA load, CD4(+) T-cell counts and liver function were determined before and after HAART. The Student's t-test or a one-way ANOVA was used for normally distributed values and A Mann-Whitney U-test was performed for values without normal distribution using SPSS statistical package 18.0 (SPSS Inc.).

Results: After HAART for 1-year, the median levels of viral load were decreased to lower limit of detection in 90.34% pediatric HIV-infected subjects with/without HBV/HCV co-infection (P < 0.001), and CD4(+) T-cell counts increased significantly (P < 0.001). Compared with the pre-HAART, mean level of alanine aminotransferase (ALT) in each group had a significant increase after HAART (P < 0.01). The mean levels of ALT and aspartate aminotransferase (AST) in nevirapine (NVP) based HAART group increased significantly after HAART (P < 0.01). Mean change values of ALT and AST were significantly higher in the NVP based regimen group than in the efavirenz (EFV) based regimen group (P < 0.01). For HIV/HBV/HCV co-infected patients, mean change values of ALT and AST in NVP-based HAART group was significantly higher than that in EFV-based HAART group (P < 0.01).

Conclusion: Highly active antiretroviral therapy can damage liver function in pediatric HIV-infected subjects, especially in those with HBV/HCV co-infection. NVP was more harmful to liver function of pediatric HIV-infected subjects than EFV.

No MeSH data available.


Related in: MedlinePlus