RT journal article
T1 Changes in liver steatosis after switching from efavirenz to raltegravir among human immunodeficiency virus-infected patients with nonalcoholic fatty liver disease
A1 Macías, Juan
A1 Mancebo, María
A1 Merino, Dolores
A1 Téllez Pérez, Francisco de Paula
A1 Montes Ramírez, M. Luisa
A1 Pulido, Federico
A1 Rivero Juárez, Antonio
A1 Raffo, Miguel
A1 Pérez Pérez, Montserrat
A1 Merchante, Nicolás
A1 Cotarelo, Manuel
A1 Pineda, Juan A.
A2 Medicina
K1 HIV
K1 nonalcoholic fatty liver disease
K1 efavirenz
K1 raltegravir
AB Background. Antiretroviral drugs with a lower potential to induce hepatic steatosis in human immunodeficiency virus (HIV) infection need to be identified. We compared the effect of switching efavirenz (EFV) to raltegravir (RAL) on hepatic steatosis among HIV-infected patients with nonalcoholic fatty liver disease (NAFLD) receiving EFV plus 2 nucleoside analogues. Methods. HIV-infected patients on EFV plus tenofovir/emtricitabine or abacavir/lamivudine with NAFLD were randomized 1:1 to switch from EFV to RAL (400 mg twice daily), maintaining nucleoside analogues unchanged, or to continue with EFV plus 2 nucleoside analogues. At baseline, eligible patients should show controlled attenuation parameter (CAP) values ≥238 dB/m. Changes in hepatic steatosis at 48 weeks of follow-up over baseline levels were measured by CAP. Results. Overall, 39 patients were included, and 19 of them were randomized to switch to RAL. At week 48, median CAP for the RAL group was 250 (Q1-Q3, 221-277) dB/m and 286 (Q1-Q3, 269-314) dB/m for the EFV group (P = .035). The median decrease in CAP values was -20 (Q1-Q3, -67 to 15) dB/m for the RAL arm and 30 (Q1-Q3, -17 to 49) dB/m for the EFV group (P = .011). CAP values <238 dB/m at week 48 were observed in 9 (47%) patients on RAL and 3 (15%) individuals on EFV (P = .029). Conclusions. After 48 weeks, HIV-infected individuals switching EFV to RAL showed decreases in the degree of hepatic steatosis, as measured by CAP, compared with those continuing with EFV. In addition, the proportion of patients without significant hepatic steatosis after 48 weeks was greater for those who switched to RAL. Clinical Trials Registration. NCT01900015.
PB Oxford University Press
SN 1537-6591
YR 2017
FD 2017
LK http://hdl.handle.net/10498/36672
UL http://hdl.handle.net/10498/36672
LA eng
DS Repositorio Institucional de la Universidad de Cádiz
RD 10-nov-2026