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& Protease Inhibitors |
| By John S. James AIDS Treatment News Liver Fibrosis in HIV/Hepatitis C Co-infection: HIV Protease Inhibitors May Be Protective
This study, conducted in patients with both hepatitis C and HIV, was done to determine if protease inhibitors were really harmful to such patients, as had been reported in some cases. In fact, the opposite was found; use of protease inhibitors was associated with significantly less liver damage in this study. No one knows why, although the authors suggested several possible mechanisms. This new study is the first large, long-term followup of coinfected patients which included liver biopsy data -- which may help explain why it found different results. The new study, published in the August 2000 HEPATOLOGY, analyzed a cohort of patients who had been treated at the hospital between 1995 and 2000, and on whom careful medical records had been kept. A statistical analysis found four independent predictors of progression to cirrhosis (severe scarring of the liver): absence of protease inhibitor therapy (relative risk 4.74), heavy alcohol use (greater than or equal to 50 grams per day -- about 5 drinks a day - - relative risk 4.71), CD4 count under 200 (relative risk 2.74), and age greater than 20 years at the time of hepatitis C infection (relative risk 2.74).
This study was limited because it was not a randomized trial where patients were randomly assigned to use protease inhibitors or not, with long-term followup with liver biopsy. The authors noted that such as trial would be impossible for both ethical and practical reasons. References 1. Benhamou Y, Di Martino V, Bochet M, and others. Factors affecting liver fibrosis in human immunodeficiency virus- and hepatitis C virus-coinfected patients: Impact of protease inhibitor therapy.Hepatology. August 2001; volume 34, pages 283-287. Note For more information on hepatitis C and coinfection with HIV, see The Hepatitis Report by Michael Marco and Jeff Schouten, available at http://www.treatmentactiongroup.org (click on "HIV/HCV Coinfection"). AIDS Treatment News Published twice monthly Subscription and Editorial Office: 1233 Locust St., 5th floor Philadelphia, PA 19107 800/TREAT-1-2 toll-free email: aidsnews@critpath.org useful links: http://www.aidsnews.org/ Editor and Publisher: John S. James Associate Editor: Tadd T. Tobias Statement of Purpose: AIDS Treatment News reports on experimental and standard treatments, especially those available now. We interview physicians, scientists, other health professionals, and persons with AIDS or HIV; we also collect information from meetings and conferences, medical journals, and computer databases. Long-term survivors have usually tried many different treatments, and found combinations that work for them. AIDS Treatment News does not recommend particular therapies, but seeks to increase the options available. AIDS Treatment News is published 24 times per year, on the first and third Friday of every month, and print copies are sent by first class mail. Email is available (see below). Back issues are available at http://www.aidsnews.org/ To subscribe, you can call 800-TREAT-1-2 or 415-255-0588: |
A study of 182 patients at a major hospital in France
suggests that HIV protease inhibitors may help to reduce
liver fibrosis and cirrhosis in patients with both HIV and
hepatitis C.(1)
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