Virology Research Today is a free monthly online journal that collates and summarizes the latest research about Virology, including details on viruses, pathology, classification, definitions. | ||||||||
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Hepatotoxicity of nevirapine in virologically suppressed patients according to gender and CD4 cell counts.De Lazzari E, León A, Arnaiz JA, Martinez E, Knobel H, Negredo E, Clotet B, Montaner J, Storfer S, Asenjo MA, Mallolas J, Miró JM, Gatell JM Biostatistic Unit, Hospital Clinic, University of Barcelona, Spain. OBJECTIVES: A warning advising a higher risk of hepatotoxicity in antiretroviral-naive patients starting a nevirapine-containing combination antiretroviral therapy (NcART) has been issued by health authorities. It is unclear whether this higher risk also applies to stable virologically suppressed patients starting NcART. METHODS: We performed a meta-analysis of published randomized studies including virologically suppressed patients who switched to NcART with a follow-up >or=3 months. CD4 cell cell counts were classified as high (HCD4) (400 cells/microL for males and 250 cells/microL for females) or low (LCD4). The main endpoint was hepatotoxicity within the first 3 months. RESULTS: Four studies with a pooled total of 410 patients were included. The risk of hepatotoxicity within the first 3 months was 2% and 4% in the LCD4 and HCD4 groups, respectively, with a combined odds ratio of 1.46 [95% confidence interval (CI) 0.43-4.98; P=0.54]. The risk of hepatotoxicity at any point during the study was similar in both groups, with a combined hazard ratio of 0.8 (95% CI 0.3-2.5; P=0.80). CONCLUSIONS: In our study, virologically suppressed patients switching to nevirapine did not have a significantly higher risk of hepatotoxicity or rash when stratified by gender and CD4 cell count, although small differences may have gone undetected because of the sample size limitation. Published 27 March 2008 in HIV Med, 9(4): 221-6.
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