Incidence and risk factors of skin rashes and hepatotoxicity in HIV-infected patients receiving nevirapine-containing combination antiretroviral therapy in Taiwan.
OBJECTIVES
To retrospectively investigate the incidence of and factors associated with skin rashes and hepatotoxicity in HIV-infected patients who initiated combination antiretroviral therapy (cART) containing nevirapine plus two nucleos(t)ide reverse-transcriptase inhibitors.


METHODS
The medical records of HIV-infected adult patients who started nevirapine-containing cART and continued follow-up for ≥4 weeks were reviewed at two hospitals in Taiwan between 2000 and 2012. Clinical data obtained at baseline and during follow-up were collected and analyzed.


RESULTS
Of the 338 patients included in the analysis, 13.0% tested positive for hepatitis B virus surface antigen and 7.9% tested positive for anti-hepatitis C virus antibody. The incidence of rashes was 21.6% and of hepatotoxicity was 25.5%. On multiple logistic regression analysis, a two-fold or greater increase from the upper limit of normal levels of aminotransferases at baseline was associated with rashes (adjusted odds ratio (aOR) 3.74, 95% confidence interval (CI) 1.56-8.96); higher CD4 counts (aOR for per 50 cells/μl increase 1.51, 95% CI 1.12-2.03) and the concurrent use of trimethoprim/sulfamethoxazole (aOR 14.01, 95% CI 1.98-98.95) were associated with hepatotoxicity.


CONCLUSIONS
Abnormal liver function at baseline was significantly associated with skin rashes, while a higher CD4 count and the concurrent use of trimethoprim/sulfamethoxazole were associated with hepatotoxicity after the initiation of nevirapine-containing cART in HIV-infected Taiwanese patients.
['Tseng|Yu-Tzu|YT|', 'Yang|Chia-Jui|CJ|', 'Chang|Sui-Yuan|SY|', 'Lin|Shu-Wen|SW|', 'Tsai|Mao-Song|MS|', 'Liu|Wen-Chun|WC|', 'Wu|Pei-Ying|PY|', 'Su|Yi-Ching|YC|', 'Luo|Yu-Zhen|YZ|', 'Yang|Shang-Ping|SP|', 'Hung|Chien-Ching|CC|', 'Chang|Shan-Chwen|SC|']
D000328:Adult D019380:Anti-HIV Agents D004359:Drug Therapy, Combination D005076:Exanthema D005260:Female D015658:HIV Infections D018937:Hepatitis C Antibodies D006801:Humans D015994:Incidence D008099:Liver D008297:Male D008875:Middle Aged D019829:Nevirapine D012189:Retrospective Studies D018894:Reverse Transcriptase Inhibitors D012307:Risk Factors D013624:Taiwan
Combination antiretroviral therapy Antiretroviral therapy Allergy Hypersensitivity Non-nucleoside reverse-transcriptase inhibitor Toxic hepatitis