Didanosine Linked to Hepatic Decompensation

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Didanosine Linked to Hepatic Decompensation During Interferon-Ribavirin

Treatment of HCV

By Will Boggs, MD

NEW YORK (Reuters Health) Dec 23 - Didanosine use is associated with an

increased risk of hepatic decompensation in patients coinfected with HIV and

hepatitis C virus (HCV) during interferon-ribavirin combination treatment,

according to a report in the December 15th Clinical Infectious Diseases.

" [One should] avoid HIV treatment with high mitochondrial toxicity in HCV or

HBV co-infected patients, in order to prevent a rapid evolution to

cirrhosis, " Dr. Firouze Bani-Sadr from Hopital Saint Antoine, Paris, France

told Reuters Health.

After observing a disturbing rate of spontaneous hepatic decompensation

among HIV-HCV-coinfected patients in a trial of interferon and ribavirin,

Dr. Bani-Sadr and colleagues analyzed the biological and clinical features

of, outcome of, and possible risk factors for spontaneous hepatic

decompensation in 7 of 383 patients involved in the trial.

HCV RNA load did not increase significantly before hepatic decompensation,

the authors report. Five of the seven patients died as a result of their

hepatic decompensation.

In a multivariate analysis, the use of didanosine was associated with an

8.8-fold increased risk of hepatic decompensation. Pre-existing cirrhosis

and a bilirubin level greater than the upper limit of normal were also

associated with spontaneous hepatic decompensation.

Spontaneous hepatic decompensation was not associated with age, sex, body

mass index, clinical markers of HIV, or the use of antiretroviral drugs

other than didanosine.

" Because HIV-infected patients with hepatitis C require treatment for HCV

infection, clinician should be aware of the potential overlapping toxicity

of treatments for HCV-HIV coinfection, " the investigators write.

" I recommend to never treat HCV-HIV or HBV-HIV co-infected patients with

didanosine, " Dr. Bani-Sadr said.

" This could enhance the safety of treatments for HIV-HCV coinfection,

notably by helping to avoid hepatic decompensation, " the authors conclude.

Clin Infect Dis 2005;41:1806-1809.

http://www.medscape.com/viewarticle/520464

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[Guest guest]

Didanosine Linked to Hepatic Decompensation During Interferon-Ribavirin

Treatment of HCV

By Will Boggs, MD

NEW YORK (Reuters Health) Dec 23 - Didanosine use is associated with an

increased risk of hepatic decompensation in patients coinfected with HIV and

hepatitis C virus (HCV) during interferon-ribavirin combination treatment,

according to a report in the December 15th Clinical Infectious Diseases.

" [One should] avoid HIV treatment with high mitochondrial toxicity in HCV or

HBV co-infected patients, in order to prevent a rapid evolution to

cirrhosis, " Dr. Firouze Bani-Sadr from Hopital Saint Antoine, Paris, France

told Reuters Health.

After observing a disturbing rate of spontaneous hepatic decompensation

among HIV-HCV-coinfected patients in a trial of interferon and ribavirin,

Dr. Bani-Sadr and colleagues analyzed the biological and clinical features

of, outcome of, and possible risk factors for spontaneous hepatic

decompensation in 7 of 383 patients involved in the trial.

HCV RNA load did not increase significantly before hepatic decompensation,

the authors report. Five of the seven patients died as a result of their

hepatic decompensation.

In a multivariate analysis, the use of didanosine was associated with an

8.8-fold increased risk of hepatic decompensation. Pre-existing cirrhosis

and a bilirubin level greater than the upper limit of normal were also

associated with spontaneous hepatic decompensation.

Spontaneous hepatic decompensation was not associated with age, sex, body

mass index, clinical markers of HIV, or the use of antiretroviral drugs

other than didanosine.

" Because HIV-infected patients with hepatitis C require treatment for HCV

infection, clinician should be aware of the potential overlapping toxicity

of treatments for HCV-HIV coinfection, " the investigators write.

" I recommend to never treat HCV-HIV or HBV-HIV co-infected patients with

didanosine, " Dr. Bani-Sadr said.

" This could enhance the safety of treatments for HIV-HCV coinfection,

notably by helping to avoid hepatic decompensation, " the authors conclude.

Clin Infect Dis 2005;41:1806-1809.

http://www.medscape.com/viewarticle/520464

_________________________________________________________________

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[Guest guest]

Didanosine Linked to Hepatic Decompensation During Interferon-Ribavirin

Treatment of HCV

By Will Boggs, MD

NEW YORK (Reuters Health) Dec 23 - Didanosine use is associated with an

increased risk of hepatic decompensation in patients coinfected with HIV and

hepatitis C virus (HCV) during interferon-ribavirin combination treatment,

according to a report in the December 15th Clinical Infectious Diseases.

" [One should] avoid HIV treatment with high mitochondrial toxicity in HCV or

HBV co-infected patients, in order to prevent a rapid evolution to

cirrhosis, " Dr. Firouze Bani-Sadr from Hopital Saint Antoine, Paris, France

told Reuters Health.

After observing a disturbing rate of spontaneous hepatic decompensation

among HIV-HCV-coinfected patients in a trial of interferon and ribavirin,

Dr. Bani-Sadr and colleagues analyzed the biological and clinical features

of, outcome of, and possible risk factors for spontaneous hepatic

decompensation in 7 of 383 patients involved in the trial.

HCV RNA load did not increase significantly before hepatic decompensation,

the authors report. Five of the seven patients died as a result of their

hepatic decompensation.

In a multivariate analysis, the use of didanosine was associated with an

8.8-fold increased risk of hepatic decompensation. Pre-existing cirrhosis

and a bilirubin level greater than the upper limit of normal were also

associated with spontaneous hepatic decompensation.

Spontaneous hepatic decompensation was not associated with age, sex, body

mass index, clinical markers of HIV, or the use of antiretroviral drugs

other than didanosine.

" Because HIV-infected patients with hepatitis C require treatment for HCV

infection, clinician should be aware of the potential overlapping toxicity

of treatments for HCV-HIV coinfection, " the investigators write.

" I recommend to never treat HCV-HIV or HBV-HIV co-infected patients with

didanosine, " Dr. Bani-Sadr said.

" This could enhance the safety of treatments for HIV-HCV coinfection,

notably by helping to avoid hepatic decompensation, " the authors conclude.

Clin Infect Dis 2005;41:1806-1809.

http://www.medscape.com/viewarticle/520464

_________________________________________________________________

Express yourself instantly with MSN Messenger! Download today - it's FREE!

http://messenger.msn.click-url.com/go/onm00200471ave/direct/01/

[Guest guest]

Didanosine Linked to Hepatic Decompensation During Interferon-Ribavirin

Treatment of HCV

By Will Boggs, MD

NEW YORK (Reuters Health) Dec 23 - Didanosine use is associated with an

increased risk of hepatic decompensation in patients coinfected with HIV and

hepatitis C virus (HCV) during interferon-ribavirin combination treatment,

according to a report in the December 15th Clinical Infectious Diseases.

" [One should] avoid HIV treatment with high mitochondrial toxicity in HCV or

HBV co-infected patients, in order to prevent a rapid evolution to

cirrhosis, " Dr. Firouze Bani-Sadr from Hopital Saint Antoine, Paris, France

told Reuters Health.

After observing a disturbing rate of spontaneous hepatic decompensation

among HIV-HCV-coinfected patients in a trial of interferon and ribavirin,

Dr. Bani-Sadr and colleagues analyzed the biological and clinical features

of, outcome of, and possible risk factors for spontaneous hepatic

decompensation in 7 of 383 patients involved in the trial.

HCV RNA load did not increase significantly before hepatic decompensation,

the authors report. Five of the seven patients died as a result of their

hepatic decompensation.

In a multivariate analysis, the use of didanosine was associated with an

8.8-fold increased risk of hepatic decompensation. Pre-existing cirrhosis

and a bilirubin level greater than the upper limit of normal were also

associated with spontaneous hepatic decompensation.

Spontaneous hepatic decompensation was not associated with age, sex, body

mass index, clinical markers of HIV, or the use of antiretroviral drugs

other than didanosine.

" Because HIV-infected patients with hepatitis C require treatment for HCV

infection, clinician should be aware of the potential overlapping toxicity

of treatments for HCV-HIV coinfection, " the investigators write.

" I recommend to never treat HCV-HIV or HBV-HIV co-infected patients with

didanosine, " Dr. Bani-Sadr said.

" This could enhance the safety of treatments for HIV-HCV coinfection,

notably by helping to avoid hepatic decompensation, " the authors conclude.

Clin Infect Dis 2005;41:1806-1809.

http://www.medscape.com/viewarticle/520464

_________________________________________________________________

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