| Hsiao FY |
------>authors3_c= ------>paper_class1=2 ------>Impact_Factor=None ------>paper_class3=0 ------>paper_class2=0 ------>vol= ------>confirm_bywho=None ------>insert_bywho=m001089023 ------>Jurnal_Rank=None ------>authors4_c= ------>comm_author= ------>patent_EDate=None ------>authors5_c= ------>publish_day=7 ------>paper_class2Letter=None ------>page2= ------>medlineContent= ------>unit=G0100 ------>insert_date=20081212 ------>iam=4 ------>update_date=None ------>author=??? ------>change_event=1 ------>ISSN= ------>authors_c= ------>score=12 ------>journal_name= ------>paper_name=A Retrospective Surveillance of Antituberculosis Therapy- Induced Hepatotoxicity. ------>confirm_date=None ------>tch_id=093056 ------>pmid=17545706 ------>page1= ------>fullAbstract=OBJECTIVE: Hepatotoxicity is a significant complication of antiretroviral therapy (ART). We assessed the incidence of and risk factors for hepatotoxicity among HIV-infected individuals on ART in South Africa. DESIGN: We conducted a retrospective cohort study in a workplace HIV care program in South Africa which uses a first-line regimen of efavirenz, zidovudine, and lamivudine and provides routine clinical and laboratory monitoring. METHODS: We included subjects with baseline and follow-up alanine transaminase and aspartate aminotransferase tests. Severe hepatotoxicity cases were identified during the first 12 months of ART. Potential risk factors, including concomitant medication use, tuberculosis, and hepatitis B and C, were determined from clinical records, database queries, and serological testing. Associations with hepatotoxicity were investigated using Cox proportional hazards modeling. RESULTS: Of the 868 subjects (94% male, median age 41 years), the median nadir CD4 cell count was 136/microl, 25% received concomitant tuberculosis treatment during ART, and 17% of a randomly selected subset were positive for hepatitis B surface antigen (HBsAg). We identified 7.7 episodes of severe hepatotoxicity per 100 person-years. Tuberculosis treatment increased risk 8.5 fold, positive HBsAg 3.0 fold, and nadir CD4 cells count < 100/microl 1.9 fold. Importantly, the fraction of patients with severe hepatotoxicity on ART (4.6%) was similar to the fraction with liver enzyme elevations > 5 times the upper limit of normal before starting ART (4%). CONCLUSIONS: In this African ART cohort, we found a low incidence of and minimal morbidity due to hepatotoxicity. HBsAg and concomitant tuberculosis therapy significantly increased the risk of hepatotoxicity. ------>tmu_sno=None ------>sno=20777 ------>authors2=Lee CN ------>authors3=Lee JA ------>authors4=Lin YM ------>authors5= ------>authors6= ------>authors6_c= ------>authors=Hsiao FY ------>delete_flag=0 ------>SCI_JNo=None ------>authors2_c= ------>publish_area=1 ------>updateTitle=Hepatotoxicity in an African antiretroviral therapy cohort: the effect of tuberculosis and hepatitis B. ------>language=2 ------>check_flag=None ------>submit_date=None ------>country=NULL ------>no= ------>patent_SDate=None ------>update_bywho=None ------>publish_year=2004 ------>submit_flag=None ------>publish_month=9 |