The role of nucleoside and nucleotide analogues in nodular regenerative hyperplasia in HIV-infected patients: A case control study

被引:29
作者
Cotte, Laurent [1 ,2 ]
Benet, Thomas [3 ]
Billioud, Claire [1 ]
Miailhes, Patrick [1 ,2 ]
Scoazec, Jean-Yves [1 ,3 ]
Ferry, Tristan [1 ,3 ]
Brochier, Corinne [1 ]
Boibieux, Andre [1 ]
Vanhems, Philippe [1 ,3 ]
Chevallier, Michele [4 ]
Zoulim, Fabien [1 ,2 ,3 ]
机构
[1] Hosp Civils Lyon, Lyon, France
[2] INSERM, U871, F-69008 Lyon, France
[3] Univ Lyon, Lyon, France
[4] Lab BIOMNIS, Lyon, France
关键词
Nodular regenerative hyperplasia; Non-cirrhotic portal hypertension; HIV; Nucleoside; Didanosine; Stavudine; Tenofovir; NONCIRRHOTIC PORTAL-HYPERTENSION; TENOFOVIR DISOPROXIL FUMARATE; CHRONIC LIVER-DISEASE; ANTIRETROVIRAL THERAPY; ASSOCIATION; DIDANOSINE; DEATH; DRUG;
D O I
10.1016/j.jhep.2010.07.030
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background & Aims: Nodular regenerative hyperplasia (NRH) leading to non-cirrhotic portal hypertension has been described in HIV-infected patients and has been linked to didanosine. The relation between NRH and other antiretrovirals remains unclear. Methods: A case-control study was performed in 13 patients with NRH and 78 controls matched for time of inclusion, baseline CD4, and duration of follow-up. Univariate and multivariate conditional logistic regression analyses were performed. Results: Control patients and patients with NRH were similar at baseline regarding demographics and biological data with the exception of older age for patients with NRH (43.9 vs. 33.5 years, p = 0.044). At the time of NRH diagnosis, cases had a lower CD4 count (327 vs. 468/mm(3), p = 0.013), a similar CD4 percentage (24 vs. 26.2%, p = 0.7), a lower platelet count (169 vs. 228 giga/L, p = 0.003) and a higher AST level (33 vs. 26 IU/L, p = 0.001) than controls. Univariate analysis demonstrated that patients with NRH had been exposed longer than controls to didanosine, stavudine, tenofovir, didanosine + stavudine, and didanosine + tenofovir. The age at baseline [OR 2.2 (1.0-5.0) per 10 years, p = 0.053] and didanosine + stavudine cumulative exposure [OR 3.7 (1.4-10.2) per year, p = 0.011] were independently associated with NRH. The age at baseline [OR 2.3 (1.0-5.3) per 10 years, p = 0.045], cumulative exposure to didanosine [OR 1.4 (1.1-1.9) per year, p = 0.023] and to tenofovir [OR 1.7 (1.0-2.8) per year, p = 0.04] were independently associated with NRH when didanosine + stavudine exposure was excluded from the model. Conclusions: NRH in HIV-infected patients seems strongly related to age and the cumulative exposure to didanosine + stavudine, didanosine, and stavudine. (c) 2010 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
引用
收藏
页码:489 / 496
页数:8
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