Antiretroviral Therapy in Patients with Hepatitis and HIV: Weighing Risks and Benefits

[Guest guest]

Clinical Infectious Diseases 2004;38:S109-S113

© 2004 by the Infectious Diseases Society of America. All rights reserved.

1058-4838/2004/3805S2-0011$15.00

Antiretroviral Therapy in Patients with Hepatitis and HIV: Weighing Risks

and Benefits

G. Powderly

Division of Infectious Diseases, Washington University School of Medicine,

St. Louis, Missouri

Liver disease is an important complication of human immunodeficiency virus

(HIV) infection. As HIV-infected patients live longer, they develop

long-term manifestations of chronic HIV infection and/or treatment

complications. Progressive liver disease is one of the leading causes of

morbidity and mortality in this patient group. Underlying hepatitis B and/or

C virus infection is extremely common. All classes of antiretroviral drugs

have been associated with some hepatotoxicity, and patients often receive

other potentially liver-damaging drugs. Alcohol use is common and frequently

underestimated. All of these issues make liver disease an important factor

in making antiretroviral decisions. Clinicians should weigh underlying

disease, behavioral issues such as drugs and alcohol, and concomitant

therapy when choosing antiretrovirals in such patients. We need more

research in this area, especially with regard to mechanisms, risks, and

managementfor specific drugs and regimensto ensure that our patients receive

the benefits of antiretroviral therapy in the safest manner possible.

[Guest guest]

Clinical Infectious Diseases 2004;38:S109-S113

© 2004 by the Infectious Diseases Society of America. All rights reserved.

1058-4838/2004/3805S2-0011$15.00

Antiretroviral Therapy in Patients with Hepatitis and HIV: Weighing Risks

and Benefits

G. Powderly

Division of Infectious Diseases, Washington University School of Medicine,

St. Louis, Missouri

Liver disease is an important complication of human immunodeficiency virus

(HIV) infection. As HIV-infected patients live longer, they develop

long-term manifestations of chronic HIV infection and/or treatment

complications. Progressive liver disease is one of the leading causes of

morbidity and mortality in this patient group. Underlying hepatitis B and/or

C virus infection is extremely common. All classes of antiretroviral drugs

have been associated with some hepatotoxicity, and patients often receive

other potentially liver-damaging drugs. Alcohol use is common and frequently

underestimated. All of these issues make liver disease an important factor

in making antiretroviral decisions. Clinicians should weigh underlying

disease, behavioral issues such as drugs and alcohol, and concomitant

therapy when choosing antiretrovirals in such patients. We need more

research in this area, especially with regard to mechanisms, risks, and

managementfor specific drugs and regimensto ensure that our patients receive

the benefits of antiretroviral therapy in the safest manner possible.

[Guest guest]

Clinical Infectious Diseases 2004;38:S109-S113

© 2004 by the Infectious Diseases Society of America. All rights reserved.

1058-4838/2004/3805S2-0011$15.00

Antiretroviral Therapy in Patients with Hepatitis and HIV: Weighing Risks

and Benefits

G. Powderly

Division of Infectious Diseases, Washington University School of Medicine,

St. Louis, Missouri

Liver disease is an important complication of human immunodeficiency virus

(HIV) infection. As HIV-infected patients live longer, they develop

long-term manifestations of chronic HIV infection and/or treatment

complications. Progressive liver disease is one of the leading causes of

morbidity and mortality in this patient group. Underlying hepatitis B and/or

C virus infection is extremely common. All classes of antiretroviral drugs

have been associated with some hepatotoxicity, and patients often receive

other potentially liver-damaging drugs. Alcohol use is common and frequently

underestimated. All of these issues make liver disease an important factor

in making antiretroviral decisions. Clinicians should weigh underlying

disease, behavioral issues such as drugs and alcohol, and concomitant

therapy when choosing antiretrovirals in such patients. We need more

research in this area, especially with regard to mechanisms, risks, and

managementfor specific drugs and regimensto ensure that our patients receive

the benefits of antiretroviral therapy in the safest manner possible.

[Guest guest]

Clinical Infectious Diseases 2004;38:S109-S113

© 2004 by the Infectious Diseases Society of America. All rights reserved.

1058-4838/2004/3805S2-0011$15.00

Antiretroviral Therapy in Patients with Hepatitis and HIV: Weighing Risks

and Benefits

G. Powderly

Division of Infectious Diseases, Washington University School of Medicine,

St. Louis, Missouri

Liver disease is an important complication of human immunodeficiency virus

(HIV) infection. As HIV-infected patients live longer, they develop

long-term manifestations of chronic HIV infection and/or treatment

complications. Progressive liver disease is one of the leading causes of

morbidity and mortality in this patient group. Underlying hepatitis B and/or

C virus infection is extremely common. All classes of antiretroviral drugs

have been associated with some hepatotoxicity, and patients often receive

other potentially liver-damaging drugs. Alcohol use is common and frequently

underestimated. All of these issues make liver disease an important factor

in making antiretroviral decisions. Clinicians should weigh underlying

disease, behavioral issues such as drugs and alcohol, and concomitant

therapy when choosing antiretrovirals in such patients. We need more

research in this area, especially with regard to mechanisms, risks, and

managementfor specific drugs and regimensto ensure that our patients receive

the benefits of antiretroviral therapy in the safest manner possible.