Palmon Ron, Koo Bon Chang A, Shoultz David A, Dieterich Douglas T
Department of Medicine, New York University School of Medicine, New York City, New York, USA.
J Acquir Immune Defic Syndr. 2002 Apr 1;29(4):340-5. doi: 10.1097/00126334-200204010-00003.
Nonnucleoside reverse transcriptase inhibitors (NNRTIs), particularly nevirapine, have been associated with hepatotoxicity. We performed a retrospective study to determine the incidence of NNRTI hepatotoxicity in a group of HIV-infected patients from a New York City practice. These patients are predominantly homosexual white males. We also analyzed the effect of coinfection with hepatitis B (HBV) or hepatitis C (HCV) virus. In total, 272 patients received NNRTIS: 40 (15%) received delavirdine, 91 (33%) received efavirenz, and 141 (52%) received nevirapine. Of the patients with known hepatitis status, 18 of 190 (9%) were coinfected with HBV, and 24 of 205 were coinfected (12%) with HCV. The overall rate of grade 3 to 4 elevations in aspartate aminotransferase (AST) or alanine aminotransferase (ALT) was 3 of 272 (1.1%) and did not differ significantly among the three NNRTIs. HBV or HCV was not associated with a significant increase in AST or ALT elevations. We conclude that NNRTIs are relatively free from hepatotoxicity in this population, despite the presence of coinfection with HBV or HCV.
非核苷类逆转录酶抑制剂（NNRTIs），尤其是奈韦拉平，与肝毒性有关。我们进行了一项回顾性研究，以确定纽约市一家诊所中一组HIV感染患者中NNRTI肝毒性的发生率。这些患者主要是同性恋白人男性。我们还分析了合并感染乙型肝炎（HBV）或丙型肝炎（HCV）病毒的影响。总共有272名患者接受了NNRTIs治疗：40名（15%）接受地拉韦定，91名（33%）接受依非韦伦，141名（52%）接受奈韦拉平。在已知肝炎状况的患者中，190名中有18名（9%）合并感染HBV，205名中有24名（12%）合并感染HCV。天冬氨酸转氨酶（AST）或丙氨酸转氨酶（ALT）3至4级升高的总体发生率为272名患者中有3名（1.1%），在三种NNRTIs之间无显著差异。HBV或HCV与AST或ALT升高的显著增加无关。我们得出结论，尽管存在HBV或HCV合并感染，但在该人群中NNRTIs相对无肝毒性。
