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Are Specific Antiretrovirals associated with an Increased Risk of Discontinuation due to Toxicities or Patient/Physician Choice in patients with Hepatitis C Virus Coinfection?

2005; SAGE Publishing; Volume: 10; Issue: 7 Linguagem: Inglês

10.1177/135965350501000704

2040-2058

Amanda Mocroft, Jürgen K. Rockstroh, Vincent Soriano, Bruno Ledergerber, Ole Kirk, Elena Vinogradova, Peter Reiss, Christine Katlama, Andrew Phillips, Jens Lundgren, M Losso, Adriana Durán, Norman Vetter, Igor Karpov, Anna Vassilenko, Nathan Clumeck, Sanne de Wit, Bénédicte Poll, Ladislav Machala, H Rozsypal, Dalibor Sedláček, Jens Nielsen, Jens Lundgren, Thomas Benfield, Ole Kirk, J Gerstoft, Terese L. Katzenstein, Ann‐Brit Eg Hansen, Peter Skinhøj, Christian Pedersen, Kai Zilmer, Christine Katlama, J-P Viard, PM Girard, T. Saint Marc, Philippe Vanhems, Christian Pradier, François Dabis, Michael Dietrich, C. Manegold, Jan van Lunzen, HJ Stellbrink, Schlomo Staszewski, Markus Bickel, F-D Goebel, Gerd Fätkenheuer, J Rockstroh, Reinhold Schmidt, J. Kosmidis, Panagiotis Gargalianos, Helen Sambatakou, J. Perdios, George Panos, Dénes Bánhegyi, F Mulcahy, Israel Yust, Dan Turner, Michael Burke, Simcha Pollack, Gamal Hassoun, Zev Sthoeger, Shlomo Maayan, Stefano Vella, Antonio Chiesi, Cumhur Arıcı, R. Pristerà, Francesco Mazzotta, Andrea Gabbuti, Roberto Esposito, Andrea Bedini, Antonio Chirianni, E. Montesarchio, Vincenzo Vullo, P Santopadre, Pasquale Narciso, Andrea Antinori, Paolo Franci, Maria Carla Re, Adriano Lazzarin, Renato Finazzi, Antonella d’Arminio Monforte, Ludmila Vīksna, Saulius Chaplinskas, R Hemmer, T Staub, P Reiss, Johan N. Bruun, A Mæland, Vidar Ormaasen, Brygida Knysz, Jacek Gąsiorowski, Andrzéj Horban, D Prokopowicz, Alicja Wiercińska‐Drapało, Anna Boroń‐Kaczmarska, M. Pynka, Marek Beniowski, E. Mularska, H Trocha, Francisco Antunes, Emília Valadas, Kamal Mansinho, F. Matez, Dan Duiculescu, Adrian Streinu‐Cercel, Elena Vinogradova, Aza Rakhmanova, Djordje Jevtović, M Mokrás, D Staneková, Juan González‐Lahoz, Matilde Sánchez‐Conde, Teresa García-Benayas, Luz Martín‐Carbonero, Vincent Soriano, Bonaventura Clotet, Antoni Jou, J. Alberto Conejero, Cristina Tural, JM Gatell, JM Miró, Anders Blaxhult, Anna Karlsson, P Pehrson, Bruno Ledergerber, Rainer Weber, P Francioli, Amalio Telenti, Bernard Hirschel, V Soravia-Dunand, Hansjakob Furrer, Nelly Chentsova, Sarah Barton, Margaret Johnson, D Mercey, Andrew Phillips, MA Johnson, Amanda Mocroft, M. Lois Murphy, J Weber, G Scullard, Martin Fisher, R P Brettle, Clive Loveday, Bonaventura Clotet, Francisco Antunes, Anders Blaxhult, Nathan Clumeck, José M. Gatell, Andrzéj Horban, Margaret Johnson, Christine Katlama, Bruno Ledergerber, Clive Loveday, Andrew Phillips, Peter Reiss, Stefano Vella, Jens Lundgren, Ida Gjørup, Ole Kirk, N Friis-Moeller, Amanda Mocroft, Alessandro Cozzi‐Lepri, Wendy Bannister, D Mollerup, D. Podlevkareva, Christian Holkmann Olsen, Jesper Kjær,

Pneumocystis jirovecii pneumonia detection and treatment

Background Liver damage associated with hepatitis C (HCV) may influence the likelihood of experiencing discontinuation due to toxicities or patient/physician choice (TOXPC) in patients taking combination antiretroviral therapy (cART). Little information to address this concern is available from clinical trials as patients with HCV are often excluded. Aims To compare incidence rates of discontinuation due to TOXPC associated with specific antiretrovial drugs in patients with or without HCV. Patients/methods A total of 4929 patients from EuroSIDA under follow-up from January 1999 on a specific nucleoside pair (zidovudine/lamivudine, didanosine/stavudine, stavudine/lamivudine, or other) with a third drug (abacavir, nelfinavir, indinavir, nevirapine, efavirenz, lopinavir/ ritonavir or other boosted-protease inhibitor (PI)-containing regimen) and with known HCV serostatus were studied for the incidence of discontinuation of any nucleoside pair or third drug due to TOXPC. Incidence rate ratios were derived from Poisson regression models. Results In total 1358 patients had HCV (27.5%). During 12 799 person-years of follow-up there were 2141 discontinuations due to TOXPC for nucleoside pairs and 2501 for third drugs. The incidence of discontinuation due to TOXPC was consistently higher in patients with HCV after stratification by nucleoside pair or third drug. After adjustment for CD4 + count, gender, exposure group, time on HAART, region and treatment regimen, there were few differences in the rate of discontinuation due to TOXPC in those with HCV compared with those without for any nucleoside pairs or third drugs. Similar results were seen when concentrating on discontinuation due to toxicities alone. Conclusions Although patients with HCV generally had higher rates of discontinuation due to TOXPC compared with patients without HCV, there was little evidence to suggest that this was associated with any specific nucleoside pair or third drug used as part of cART. Our results do not suggest that any specific component of cART is more poorly tolerated in patients with HCV or that the presence of HCV should influence the choice between antiretrovirals used as part of a cART regimen.