Chronic Liver Enzyme Elevation and Use of Contemporary ARVs Among People With HIV
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Chronic Liver Enzyme Elevation and Use of Contemporary ARVs Among People With HIV. / Roen, Ashley O.; Peters, Lars; Wandeler, Gilles; van der Valk, Marc; Zangerle, Robert; Günthard, Huldrych F.; Wit, Ferdinand; Mussini, Cristina; De Wit, Stéphane; d’Arminio Monforte, Antonella; Vehreschild, Jörg Janne; Castagna, Antonella; Jaschinski, Nadine; Vannappagari, Vani; Chen, Linda; Tallada, Joan; C’mar, John; Mocroft, Amanda; Ryom, Lene.
In: Open Forum Infectious Diseases, Vol. 11, No. 6, ofae308, 2024.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Chronic Liver Enzyme Elevation and Use of Contemporary ARVs Among People With HIV
AU - Roen, Ashley O.
AU - Peters, Lars
AU - Wandeler, Gilles
AU - van der Valk, Marc
AU - Zangerle, Robert
AU - Günthard, Huldrych F.
AU - Wit, Ferdinand
AU - Mussini, Cristina
AU - De Wit, Stéphane
AU - d’Arminio Monforte, Antonella
AU - Vehreschild, Jörg Janne
AU - Castagna, Antonella
AU - Jaschinski, Nadine
AU - Vannappagari, Vani
AU - Chen, Linda
AU - Tallada, Joan
AU - C’mar, John
AU - Mocroft, Amanda
AU - Ryom, Lene
N1 - Publisher Copyright: © The Author(s) 2024.
PY - 2024
Y1 - 2024
N2 - Background. While use of some older antiretroviral drugs (ARVs) is associated with chronic liver enzyme elevation (cLEE), the impact of newer ARVs remains unknown. Methods. People with HIV enrolled in the RESPOND cohort who started an ARV after January 1, 2012 were included (baseline). The primary outcome was first cLEE individuals were censored at first of cLEE, last visit, death, or December 31, 2021. Incidence rates (IRs; events/1000 person-years) were calculated for each ARV overall and by ARV exposure (6–12 months, 1–2 years, and 2+ years). Poisson regression was used to estimate the incidence rate ratio (IRR) of cLEE and its association with individual ARVs and ARV class. Results. Of 17 106 individuals included contributing 87 924 person-years of follow-up, 1932 (11.3%) experienced cLEE (incidence rate [IR], 22.0; 95% CI, 21.0–23.0). There was no evidence of a cumulative ARV effect on cLEE incidence, (6–12 months: IR, 45.8; 95% CI, 41.4–50.19; 1–2 years: IR, 34.3; 95% CI, 31.5–37.4; and 2+ years: IR, 18.5; 95% CI, 17.4–19.7). Any use (vs no prior use) of non-nucleoside reverse transcriptase inhibitors (NNRTIs) as a class and tenofovir disoproxil fumarate (TDF) was independently associated with an increased IRR of cLEE, and any use of darunavir (DRV) was associated with a decreased risk of cLEE. Conclusions. cLEE is common and more frequent during the first year after initiating new ARVs. With a >5-year median follow-up, we found no short-term liver safety concerns with the use of INSTIs. Use of NNRTIs and TDF was associated with an increased cLEE risk, while DRV was associated with lower risk.
AB - Background. While use of some older antiretroviral drugs (ARVs) is associated with chronic liver enzyme elevation (cLEE), the impact of newer ARVs remains unknown. Methods. People with HIV enrolled in the RESPOND cohort who started an ARV after January 1, 2012 were included (baseline). The primary outcome was first cLEE individuals were censored at first of cLEE, last visit, death, or December 31, 2021. Incidence rates (IRs; events/1000 person-years) were calculated for each ARV overall and by ARV exposure (6–12 months, 1–2 years, and 2+ years). Poisson regression was used to estimate the incidence rate ratio (IRR) of cLEE and its association with individual ARVs and ARV class. Results. Of 17 106 individuals included contributing 87 924 person-years of follow-up, 1932 (11.3%) experienced cLEE (incidence rate [IR], 22.0; 95% CI, 21.0–23.0). There was no evidence of a cumulative ARV effect on cLEE incidence, (6–12 months: IR, 45.8; 95% CI, 41.4–50.19; 1–2 years: IR, 34.3; 95% CI, 31.5–37.4; and 2+ years: IR, 18.5; 95% CI, 17.4–19.7). Any use (vs no prior use) of non-nucleoside reverse transcriptase inhibitors (NNRTIs) as a class and tenofovir disoproxil fumarate (TDF) was independently associated with an increased IRR of cLEE, and any use of darunavir (DRV) was associated with a decreased risk of cLEE. Conclusions. cLEE is common and more frequent during the first year after initiating new ARVs. With a >5-year median follow-up, we found no short-term liver safety concerns with the use of INSTIs. Use of NNRTIs and TDF was associated with an increased cLEE risk, while DRV was associated with lower risk.
KW - ART
KW - Chronic liver enzyme elevation (cLEE)
KW - HCV
KW - HIV
U2 - 10.1093/ofid/ofae308
DO - 10.1093/ofid/ofae308
M3 - Journal article
C2 - 38919512
AN - SCOPUS:85197893564
VL - 11
JO - Open Forum Infectious Diseases
JF - Open Forum Infectious Diseases
SN - 2328-8957
IS - 6
M1 - ofae308
ER -
ID: 399159820