Rates of antiretroviral (ARV)-associated liver toxicity among people living with HIV and hepatitis C virus (HCV) have decreased since 1997, but it is still more common among people infected with both viruses compared with people infected only with HIV. This is the finding of an analysisreported Wednesday, March 7, at the 19th Conference on Retroviruses and Opportunistic Infections in Seattle.
For people living with HIV, coinfection with HCV is known to increase the risk for, and rate of, liver toxicity from ARV therapy. Hepatotoxicity was a particular concern with commonly prescribed ARVs during the early years of combination HIV treatment, notably the late 1990s and early 2000s. In more recently years, the approval of newer agents has permitted health care providers to prescribe HIV combinations heralded as being safer than their predecessors, yet it hasn’t been clear whether evolved regimens have reduced the incidence of liver toxicity among people with HIV/HCV coinfection.
To explore this question, Mark Hull, MD, from Canada’s BC Centre for Excellence in HIV/AIDS in Vancouver and his colleagues followed 748 people living with HIV-196 (26 percent) of whom were coinfected with HCV-over a span of 12 years. The study subjects were divided into three groups: those observed between January 1, 1997, until December 31, 1999 (period one); those observed between January 1, 2000, and December 31, 2003 (period two); and those observed between January 1, 2004, and December 31, 2009 (period three).
In this mostly male group averaging 42 years old, HIV treatment uptake increased over the years. During period one, 107 people (14 percent) started ARV treatment for HIV. In period two, 208 (28 percent) started ARV therapy. In period three, 433 (58 percent) began ARV treatment.