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Type: Artigo de periódico
Title: Hepatotoxicity In Hiv-infected Children And Adolescents On Antiretroviral Therapy.
Author: Gil, Ana Cecília Montes
Lorenzetti, Raquel
Mendes, Gun Bergsten
Morcillo, André Moreno
Toro, Adyléia Aparecida Dalbo Contrera
Silva, Marcos Tadeu Nolasco da
Vilela, Maria Marluce dos Santos
Abstract: Adverse drug reactions are a significant problem in patients on antiretroviral therapy (ART). We determined liver enzyme elevation frequencies in HIV-infected children and adolescents receiving ART, and their association with risk factors. Cross-sectional study, at the Pediatrics Immunodeficiency Division, University Hospital, Universidade Estadual de Campinas. Medical records of 152 children and adolescents (54.6% male; median age 7.48 years) were analyzed, with a mean of 2.6 liver enzyme determinations per patient. Clinically, patients were classified in categories N (6), A (29), B (78) and C (39). Serum levels of aspartate aminotransferase and alanine aminotransferase were evaluated. Hepatotoxicity was scored as grade 1 (1.1-4.9 times upper limit of normality, ULN), grade 2 (5.0-9.9 times ULN), grade 3 (10.0-15.0 times ULN) and grade 4 (> 15.0 times ULN). To assess hepatotoxicity risk factors, odds ratios (OR) and adjusted odds ratios (aOR) for age, gender, TCD4+ cell count, viral load and medication usage were calculated. We observed grade 1 hepatotoxicity in 19.7 % (30/152) patients. No cases of grade 2, 3 or 4 were detected. There was a significant association between hepatotoxicity and use of sulfonamides (OR, 3.61; 95% confidence interval (CI), 1.50-8.70; aOR, 3.58; 95% CI, 1.44-8.85) and antituberculous agents (OR, 9.23; 95% CI, 1.60-53.08; aOR, 9.05; 95% CI, 1.48-55.25). No toxicity was associated with ART. One fifth of patients experienced mild hepatotoxicity, attributed to antituberculous agents and sulfonamides. Our results suggest that ART was well tolerated.
Subject: Adolescent
Alanine Transaminase
Antiretroviral Therapy, Highly Active
Aspartate Aminotransferases
Drug-induced Liver Injury
Epidemiologic Methods
Hiv Infections
Hepatitis C
Viral Load
Citation: São Paulo Medical Journal = Revista Paulista De Medicina. v. 125, n. 4, p. 205-9, 2007-Jul.
Rights: aberto
Date Issue: 2007
Appears in Collections:Unicamp - Artigos e Outros Documentos

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