Limits...
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 the change values of (a) alanine aminotransferase changes; (b) aspartate aminotransferase changes; and (c) total bilirubin from baseline 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 HAART. *P < 0.01, after HAART versus pre-HAART
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4400705&req=5

Figure 2: The comparison of the change values of (a) alanine aminotransferase changes; (b) aspartate aminotransferase changes; and (c) total bilirubin from baseline 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 HAART. *P < 0.01, after HAART versus pre-HAART

Mentions: In order to evaluate whether the results were affected by basic liver enzyme elevation (LEE), the change values of ALT, AST, and total bilirubin from baseline were also analyzed. The mean change values from baseline are shown in Figure 2. Co-infected patients, compared to mono-infected patients, had higher mean ALT change values after HAART, but there was no remarkable difference between mono and co-infected patients (P > 0.05). The mean change values of AST and total bilirubin from baseline had no remarkable difference between mono and co-infected patients either (P > 0.05) [Figure 2].


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 the change values of (a) alanine aminotransferase changes; (b) aspartate aminotransferase changes; and (c) total bilirubin from baseline 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 HAART. *P < 0.01, after HAART versus pre-HAART
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 2: The comparison of the change values of (a) alanine aminotransferase changes; (b) aspartate aminotransferase changes; and (c) total bilirubin from baseline 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 HAART. *P < 0.01, after HAART versus pre-HAART
Mentions: In order to evaluate whether the results were affected by basic liver enzyme elevation (LEE), the change values of ALT, AST, and total bilirubin from baseline were also analyzed. The mean change values from baseline are shown in Figure 2. Co-infected patients, compared to mono-infected patients, had higher mean ALT change values after HAART, but there was no remarkable difference between mono and co-infected patients (P > 0.05). The mean change values of AST and total bilirubin from baseline had no remarkable difference between mono and co-infected patients either (P > 0.05) [Figure 2].

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