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Antimicrobial Agents and Chemotherapy, December 2000, p. 3451-3455, Vol. 44, No. 12
0066-4804/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.

Hepatitis B or Hepatitis C Virus Infection Is a Risk Factor for Severe Hepatic Cytolysis after Initiation of a Protease Inhibitor-Containing Antiretroviral Regimen in Human Immunodeficiency Virus-Infected Patients

Marianne Savès,1,dagger François Raffi,2,dagger Philippe Clevenbergh,3 Bruno Marchou,4 Anne Waldner-Combernoux,5,dagger Philippe Morlat,6,dagger Vincent Le Moing,7,dagger Catherine Rivière,8,dagger Geneviève Chêne,1 Catherine Leport,7,* and The APROCO Study GroupDagger

INSERM Unité 330, 33076 Bordeaux Cedex,1 CISIH, Hôtel-Dieu, 44035 Nantes Cedex,2 Service de Maladies Infectieuses et Tropicales, Hôpital de l'Archet, 06202 Nice Cedex 3,3 Service des Maladies Infectieuses et Tropicales, Hôpital Purpan, 31059 Toulouse Cedex,4 Service de Maladies Infectieuses, Hôpital Robert Debré, 51092 Reims Cedex,5 Service de Médecine Interne, Hôpital Saint-André, 33075 Bordeaux Cedex,6 Laboratoire de Recherche en Pathologie Infectieuse, Faculté Xavier Bichat, Paris Cedex 75018,7 and Département des Maladies Infectieuses, Tropicales, Parasitaires et de Santé Publique, Hôpital Pitié Salpêtrière, 75651 Paris Cedex 13,8 France

Received 7 October 1999/Returned for modification 18 January 2000/Accepted 25 August 2000

In a cohort of 1,047 human immunodeficiency virus type 1-infected patients started on protease inhibitors (PIs), the incidence of severe hepatic cytolysis (alanine aminotransferase concentration five times or more above the upper limit of the normal level >=  5N) was 5% patient-years after a mean follow-up of 5 months. Only positivity for hepatitis C virus antibodies (hazard ratio [HR], 7.95; P < 10-3) or hepatitis B virus surface antigen (HR, 6.67; P < 10-3) was associated with severe cytolysis. Before starting patients on PIs, assessment of liver enzyme levels and viral coinfections is necessary.

* Corresponding author. Mailing address: Laboratoire de Recherche en Pathologie Infectieuse, Faculté Xavier Bichat, 16 rue Henri Huchard, 75870 Paris Cedex 18, France. Phone: 00 33 144 85 61 79 or 00 33 140 25 78 03. Fax: 00 33 144 85 62 46 or 00 33 140 25 88 60. E-mail: leport{at}bch.ap-hop-paris.fr.

dagger Member of the APROCO Study Group.

Dagger Members of the APROCO Study Group are listed in the appendix.

Antimicrobial Agents and Chemotherapy, December 2000, p. 3451-3455, Vol. 44, No. 12
0066-4804/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.


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