Antivir Ther. 2006;11(5):567-74.
Impact of lamivudine on the risk of liver-related death in 2,041 HBsAg- and
HIV-positive individuals: results from an inter-cohort analysis.
Puoti M, Cozzi-Lepri A, Arici C, Moller NF, Lundgren JD, Ledergerber B,
Rickenbach M, Suarez-Lozano I, Garrido M, Dabis F, Winnock M, Milazzo L,
Gervais A, Raffi F, Gill J, Rockstroh J, Ourishi N, Mussini C, Castagna A,
De Luca A, Monforte A; HBV-HIV International Intercohort Study Group.
Clinica di Malattie Infettive e Tropical, Universita degli Studi di Brescia,
Brescia, Italy. [email protected]
BACKGROUND: The impact of lamivudine (3TC) as part of combination
antiretroviral therapy (cART) on the risk of liver-related death (LRD) in
HIV/hepatitis B virus (HBV)-coinfected patients has not been extensively
studied. METHODS: We performed an analysis involving HIV/HBV-coinfected
patients in 13 cohorts who initiated cART. The end-point was LRD--that is,
death with concomitant decompensated liver disease (DLD) or hepatocellular
carcinoma--as the main cause. Incidence rates of LRD after initiation of
cART were expressed as number of events per 100 person-years of follow-up
(PYFU). A Poisson regression model adjusted for cohort, gender, mode of HIV
transmission, CD4+ T-cell count at cART initiation, liver disease pre-cART,
duration of 3TC before cART, and hepatitis C virus was used to assess the
association between use of 3TC and risk of LRD. Results: We analysed 2,041
patients. Follow-up after starting cART was 7,648 PYFU (5,569 spent on
3TC-containing regimens) with a median per person of 48 months (range:
2-91). Of the total, 217 subjects died; 57 deaths were liver-related
resulting in a rate of 7.5 per 1,000 PYFU [95% confidence intervals (CI):
5.6-9.7]. The relative risk of LRD per extra year of 3TC use was 0.73 (95%
CI: 0.59-0.90, P = 0.004). CONCLUSION: The use of 3TC was associated with a
reduced risk of LRD over 4 years of follow-up. This study supports the
current view that the use of 3TC as part of cART should be considered in
patients who are tested positive for HBsAg.
PMID: 16964824 [PubMed - in process]
| 
发表于 2006-9-20 17:37
