Atazanavir en la coinfección por VIH y virus de la hepatitis B y/o C
Safety of atazanavir in patients with HIV and hepatitis B and/or C virus coinfection
Antonio Rivero
, Ángela Camacho, Inés Pérez-Camacho, Julián Torre-Cisneros
Autor para correspondencia
ariveror@gmail.com
Correspondencia: Dr. A. Rivero. Unidad de Gestión Clínica de Enfermedades Infecciosas. Hospital Universitario Reina Sofía. Avda. Menéndez Pidal, s/n. 14004 Córdoba.
Correspondencia: Dr. A. Rivero. Unidad de Gestión Clínica de Enfermedades Infecciosas. Hospital Universitario Reina Sofía. Avda. Menéndez Pidal, s/n. 14004 Córdoba.
Unidad de Gestión Clínica de Enfermedades Infecciosas. Hospital Universitario Reina Sofía. Córdoba. España
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Hospital Universitario Reina Sofía. Córdoba. España" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "⁎" "correspondencia" => "Correspondencia: Dr. A. Rivero. Unidad de Gestión Clínica de Enfermedades Infecciosas. Hospital Universitario Reina Sofía. Avda. Menéndez Pidal, s/n. 14004 Córdoba." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Safety of atazanavir in patients with HIV and hepatitis B and/or C virus coinfection" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec137569" "palabras" => array:4 [ 0 => "Atazanavir" 1 => "VIH-1" 2 => "Virus hepatitis C" 3 => "Virus hepatitis B" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec137568" "palabras" => array:4 [ 0 => "Atazanavir" 1 => "HIV-1" 2 => "Hepatitis virus C" 3 => "Hepatitis virus B" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">Atazanavir es un inhibidor de la proteasa indicado, en combinación con otros antirretrovirales, como tratamiento inicial de la infección por el virus de la inmunodeficiencia humana (VIH) o en pacientes pretratados. El tratamiento antirretroviral basado en atazanavir se ha relacionado con una baja frecuencia de hepatotoxicidad, tanto en ensayos clínicos como en estudio de cohortes. Sin embargo, el hallazgo de hiperbilirrubinemia ha resultado común en estos estudios, aunque usualmente no es una causa para la retirada del tratamiento. En pacientes coinfectados por virus de la hepatitis B (VHB) o C (VHC), el grado de respuesta virológica a atazanavir no se encuentra afectada y la incidencia de efectos adversos, salvo en la mayor incidencia de hepatotoxicidad, no es superior a la de los sujetos no coinfectados. La incidencia de hepatotoxicidad grave (grado 3-4) en pacientes coinfectados por el VIH y el VHC que reciben combinaciones de fármacos que incluyen atazanavir es de un 6%. Atazanavir tiene un favorable perfil de tolerabilidad y seguridad en pacientes coinfectados por virus de la hepatitis, incluso en presencia de fibrosis significativa. La menor relación de atazanavir con el desarrollo de resistencia a la insulina, hecho que se ha relacionado con una mayor velocidad de progresión de la fibrosis hepática y una menor tasa de respuesta al tratamiento, supondría un beneficio añadido del uso de atazanavir en pacientes coinfectados y podría servir de argumento adicional para su empleo en estos pacientes.</p>" ] "en" => array:1 [ "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">Atazanavir is a protease inhibitor indicated, in combination with other antiretrovirals, as an initial treatment of HIV infection or in previously treated patients. Antiretroviral treatment based on atazanavir has been associated with a low incidence of hepatotoxicity, both in Clinical Trials as well as in cohort studies. However, the finding of hyperbilirubinaemia has been common in these studies, although it usually does not involve withdrawing the treatment. In patients co-infected with hepatitis B or C, the level of virological response to does not appear to be affected and the incidence of adverse effects, except the higher incidence of hepatotoxicity, is no higher than in non-coinfected subjects. The incidence of severe hepatotoxicity (grade 3-4) in patients coinfected by HIV and HVC who receive drug combinations that contain atazanavir is 6%. Atazanavir has a favourable tolerance and safety profile in patients coinfected with hepatitis virus even in the presence of significant fibrosis. The lower association of atazanavir with the development of insulin resistance, a fact that has been associated with increasing the progression to hepatic fibrosis and lower treatment response rates, could be an added benefit of the use atazanavir in coinfected patients and could serve as an additional argument for its use in these patients.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:52 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Continued improvement in survival among HIV-infected individuals with newer forms of highly active antiretroviral therapy" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "V.D. Lima" 1 => "R.S. Hogg" 2 => "P.R. 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Octubre | 5 | 4 | 9 |
| 2024 Septiembre | 10 | 5 | 15 |
| 2024 Agosto | 9 | 3 | 12 |
| 2024 Julio | 16 | 1 | 17 |
| 2024 Junio | 8 | 2 | 10 |
| 2024 Mayo | 8 | 0 | 8 |
| 2024 Abril | 5 | 2 | 7 |
| 2024 Marzo | 8 | 2 | 10 |
| 2024 Febrero | 8 | 2 | 10 |
| 2024 Enero | 16 | 0 | 16 |
| 2023 Diciembre | 7 | 2 | 9 |
| 2023 Noviembre | 7 | 3 | 10 |
| 2023 Octubre | 14 | 2 | 16 |
| 2023 Septiembre | 8 | 1 | 9 |
| 2023 Agosto | 6 | 0 | 6 |
| 2023 Julio | 7 | 3 | 10 |
| 2023 Junio | 6 | 1 | 7 |
| 2023 Mayo | 10 | 0 | 10 |
| 2023 Abril | 25 | 7 | 32 |
| 2023 Marzo | 16 | 1 | 17 |
| 2023 Febrero | 8 | 1 | 9 |
| 2023 Enero | 3 | 2 | 5 |
| 2022 Diciembre | 8 | 6 | 14 |
| 2022 Noviembre | 16 | 7 | 23 |
| 2022 Octubre | 8 | 5 | 13 |
| 2022 Septiembre | 16 | 5 | 21 |
| 2022 Agosto | 6 | 6 | 12 |
| 2022 Julio | 10 | 9 | 19 |
| 2022 Junio | 9 | 5 | 14 |
| 2022 Mayo | 6 | 5 | 11 |
| 2022 Abril | 11 | 12 | 23 |
| 2022 Marzo | 16 | 8 | 24 |
| 2022 Febrero | 8 | 6 | 14 |
| 2022 Enero | 7 | 3 | 10 |
| 2021 Diciembre | 6 | 8 | 14 |
| 2021 Noviembre | 5 | 5 | 10 |
| 2021 Octubre | 9 | 10 | 19 |
| 2021 Septiembre | 9 | 6 | 15 |
| 2021 Agosto | 10 | 11 | 21 |
| 2021 Julio | 6 | 7 | 13 |
| 2021 Junio | 7 | 7 | 14 |
| 2021 Mayo | 6 | 7 | 13 |
| 2021 Abril | 13 | 10 | 23 |
| 2021 Marzo | 8 | 19 | 27 |
| 2021 Febrero | 10 | 9 | 19 |
| 2021 Enero | 7 | 15 | 22 |
| 2020 Diciembre | 11 | 6 | 17 |
| 2020 Noviembre | 11 | 5 | 16 |
| 2020 Octubre | 4 | 6 | 10 |
| 2020 Septiembre | 14 | 8 | 22 |
| 2020 Agosto | 8 | 10 | 18 |
| 2020 Julio | 12 | 9 | 21 |
| 2020 Junio | 3 | 3 | 6 |
| 2020 Mayo | 13 | 4 | 17 |
| 2020 Abril | 8 | 2 | 10 |
| 2020 Marzo | 8 | 5 | 13 |
| 2020 Febrero | 6 | 3 | 9 |
| 2020 Enero | 16 | 7 | 23 |
| 2019 Diciembre | 9 | 4 | 13 |
| 2019 Noviembre | 14 | 4 | 18 |
| 2019 Octubre | 9 | 4 | 13 |
| 2019 Septiembre | 12 | 6 | 18 |
| 2019 Agosto | 11 | 4 | 15 |
| 2019 Julio | 16 | 19 | 35 |
| 2019 Junio | 17 | 18 | 35 |
| 2019 Mayo | 50 | 55 | 105 |
| 2019 Abril | 30 | 30 | 60 |
| 2019 Marzo | 6 | 8 | 14 |
| 2019 Febrero | 3 | 12 | 15 |
| 2019 Enero | 0 | 3 | 3 |
| 2018 Diciembre | 1 | 5 | 6 |
| 2018 Noviembre | 3 | 3 | 6 |
| 2018 Octubre | 7 | 8 | 15 |
| 2018 Septiembre | 5 | 7 | 12 |
| 2018 Agosto | 2 | 12 | 14 |
| 2018 Julio | 2 | 10 | 12 |
| 2018 Junio | 1 | 4 | 5 |
| 2018 Mayo | 3 | 8 | 11 |
| 2018 Abril | 1 | 4 | 5 |
| 2018 Marzo | 2 | 2 | 4 |
| 2018 Febrero | 3 | 5 | 8 |
| 2018 Enero | 5 | 1 | 6 |
| 2017 Diciembre | 1 | 3 | 4 |
| 2017 Noviembre | 5 | 5 | 10 |
| 2017 Octubre | 3 | 10 | 13 |
| 2017 Septiembre | 4 | 3 | 7 |
| 2017 Agosto | 4 | 1 | 5 |
| 2017 Julio | 3 | 1 | 4 |
| 2017 Junio | 5 | 5 | 10 |
| 2017 Mayo | 9 | 1 | 10 |
| 2017 Abril | 15 | 1 | 16 |
| 2017 Marzo | 11 | 52 | 63 |
| 2017 Febrero | 7 | 1 | 8 |
| 2017 Enero | 7 | 0 | 7 |
| 2016 Diciembre | 5 | 0 | 5 |
| 2016 Noviembre | 8 | 4 | 12 |
| 2016 Octubre | 14 | 1 | 15 |
| 2016 Septiembre | 13 | 1 | 14 |
| 2016 Agosto | 11 | 2 | 13 |
| 2016 Julio | 6 | 1 | 7 |
| 2016 Junio | 11 | 10 | 21 |
| 2016 Mayo | 16 | 9 | 25 |
| 2016 Abril | 14 | 4 | 18 |
| 2016 Marzo | 11 | 7 | 18 |
| 2016 Febrero | 10 | 18 | 28 |
| 2016 Enero | 9 | 14 | 23 |
| 2015 Diciembre | 9 | 20 | 29 |
| 2015 Noviembre | 16 | 10 | 26 |
| 2015 Octubre | 10 | 13 | 23 |
| 2015 Septiembre | 13 | 12 | 25 |
| 2015 Agosto | 11 | 4 | 15 |
| 2015 Julio | 15 | 2 | 17 |
| 2015 Junio | 3 | 4 | 7 |
| 2015 Mayo | 5 | 1 | 6 |
| 2015 Abril | 10 | 7 | 17 |
| 2015 Marzo | 5 | 4 | 9 |
| 2015 Febrero | 15 | 6 | 21 |
| 2015 Enero | 19 | 7 | 26 |
| 2014 Diciembre | 22 | 11 | 33 |
| 2014 Noviembre | 26 | 5 | 31 |
| 2014 Octubre | 24 | 1 | 25 |
| 2014 Septiembre | 25 | 3 | 28 |
| 2014 Agosto | 20 | 1 | 21 |
| 2014 Julio | 28 | 2 | 30 |
| 2014 Junio | 36 | 2 | 38 |
| 2014 Mayo | 13 | 1 | 14 |
| 2014 Abril | 10 | 3 | 13 |
| 2014 Marzo | 14 | 4 | 18 |
| 2014 Febrero | 11 | 3 | 14 |
| 2014 Enero | 7 | 5 | 12 |
| 2013 Diciembre | 16 | 3 | 19 |
| 2013 Noviembre | 17 | 5 | 22 |
| 2013 Octubre | 15 | 8 | 23 |
| 2013 Septiembre | 14 | 8 | 22 |
| 2013 Agosto | 25 | 2 | 27 |
| 2013 Julio | 22 | 2 | 24 |
| 2008 Diciembre | 416 | 0 | 416 |
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