Hepatotoxicity Associated With Antiretroviral Therapy in Adults Infected With Human Immunodeficiency Virus and the Role of Hepatitis C or B Virus Infection

Article Abstract:

Ritonavir appears to be the only AIDS drug that may damage the liver. Researchers analyzed the rate of severe liver damage in 298 HIV patients who were taking various AIDS drugs. Overall, 10% of the patients developed severe liver damage. Thirty percent of those taking ritonavir developed severe liver damage compared to about 6% of the patients taking other drugs. Patients with hepatitis were more likely to develop liver toxicity, but 88% did not develop severe liver damage.

Causes of, Ritonavir, Liver diseases

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Non-Hodgkin's lymphoma in patients with advanced HIV infection treated with zidovudine

Article Abstract:

Non-Hodgkin's lymphoma (NHL, a malignancy of lymphoid tissue, the source of many types of blood cells) is a complication of human immunodeficiency virus (HIV) infection, but its development may also be facilitated by zidovudine, the drug used to treat HIV infection. To determine the extent to which zidovudine treatment might affect NHL, data were analyzed from 1,030 AIDS patients who began taking zidovudine between April 15, 1987 and April 14, 1988. The occurrence of complications of HIV infection and other disorders was noted. The demographic and clinical characteristics of patients who developed NHL while taking zidovudine (cases) were compared with characteristics of patients who did not (controls). Patients were followed for an average of 600 days after they began treatment. Twenty-four patients (2.3 percent) developed NHL in 1,463 person-years of follow-up. The probability of developing this disease was stable over the two years of zidovudine therapy. Risk factors for NHL, based on the case-control analysis, were: prior diagnosis of Kaposi's sarcoma (a malignancy associated with AIDS); prior herpes simplex virus infection; and an abnormally low neutrophil count (a type of white blood cell). Weaker risk factors for NHL were an earlier diagnosis of oral hairy leukoplakia (a mouth disease with characteristic white spots on the mucous membranes), and male homosexuality. NHL is an aggressive condition; 88 percent of the NHL patients died during later follow-up, compared with 43 percent of those who did not develop the disease. The incidence of the development of NHL in this study was similar to rates reported for other patients with advanced HIV infection who did not undergo treatment with drugs similar to zidovudine (retroviral agents). The data indicate that longer survival of people with HIV infection treated with zidovudine is likely to be associated with an increased incidence of NHL. (Consumer Summary produced by Reliance Medical Information, Inc.)

Risk factors, Non-Hodgkin's lymphomas

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Racial and ethnic differences in outcome in zidovudine-treated patients with advanced HIV disease

Article Abstract:

Zidovudine has been shown effective in reducing mortality and the incidence of new opportunistic infections in patients with advanced human immunodeficiency virus (HIV) disease. However, little information is available regarding zidovudine's effectiveness in Hispanic patients and non-white patients. This is important since blacks and Hispanics are disproportionately represented among those with acquired immune deficiency syndrome (AIDS), and the rate of development of new AIDS cases among these groups is three times that of whites. A prospective study was undertaken to determine if racial or ethnic differences exist in survival, disease progression, and development of bone marrow suppression in patients with advanced HIV disease who were treated with zidovudine. The study, carried out at 12 urban medical centers, included 754 non-Hispanic whites, 165 blacks, and 106 Hispanics. At the beginning of zidovudine treatment, Hispanic and black patients had more advanced disease than the white patients. Black patients with AIDS had a poorer prognosis than white or Hispanic patients. Survival at two years for whites was 40 percent, for blacks 27 percent, and for Hispanics 39 percent. The proportion of patients who developed pneumocystis carinii pneumonia was 46 percent for whites, 66 percent for blacks, and 44 percent for Hispanics. There was no significant racial or ethic difference in survival, development of opportunistic infections, or bone marrow suppression. Once an adjustment was made for severity of disease, black race no longer was an independent predictive factor of survival. Excessive risk for development of pneumocystis carinii pneumonia in blacks was due to differences in the use of prophylactic (preventive) measures. It is concluded that racial differences in survival, incidence of opportunistic infection, and bone marrow suppression are mostly due to more advanced disease and lack of compliance with medical regimens designed to prevent pneumocystis carinii pneumonia. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Demographic aspects, HIV patients, AIDS (Disease)

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