The Body Covers: The 41st Interscience Conference on Antimicrobial Agents and Chemotherapy
Antiretroviral Therapy I (Poster Session 193)
December 18, 2001
After 18 months follow up, 63 percent had HIV levels of 400 copies including 64 percent who were still using recreational drugs. There was no difference in the CD4 count (390 vs. 357) or HIV viral loads between the once and twice-daily regimens. Patients taking NVP vs. PIs had similar virologic responses but the NVP patients had a significantly higher CD4 count: 483 vs. 319. There was no grade 3 or 4 liver toxicity in any of the patients, which was surprising in light of the fact that all patients had hepatitis C.
This is a study that demonstrates that directly observed therapy works in methadone clinics even if drug use continues. Good virologic responses were found and the liver toxicity of HIV medications was not a problem even in the face of hepatitis C.
Considering all the bad press NVP has been receiving lately for liver toxicity (which, in my opinion, is undeserved), this is a study that is quite positive in two ways. Not only did the NVP work well raising CD4 counts but there was no serious liver toxicity in these drug-using hepatitis C patients. The extra CD4 response found in the NVP patients is interesting and is undergoing further study. Good news for the methadone crowd and their livers!
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