Hepatoxicity in an African HIV Treatment Cohort

Summary

Principal Investigator: Christopher J Hoffmann
Abstract: [unreadable] DESCRIPTION (provided by applicant): Use of antiretroviral (ARV) therapy to suppress HIV and allow immune reconstitution has shifted mortality from opportunistic infections to complications of chronic infections and ARV therapy. A significant and potentially fatal adverse effect is hepatotoxicity. Recent rapid expansion of ARV therapy in developing countries has the potential to reverse the AIDS mortality currently devastating these areas but drug toxicity may present a barrier to program success. One known risk factor for hepatotoxicity, hepatitis B (HBV), is hyper-endemic in parts of Africa. In addition to HBV, multiple other known and potential risks for hepatotoxicity may exist including alcohol, traditional medicines, and tropical diseases. We propose to test the hypothesis that the incidence of ARV-related hepatotoxicity is greater in Africa than in North America and that risk factors differ. This study will measure incidence of hepatotoxicity in an African ARV therapy cohort and identify risks for hepatotoxicity by matching cases with controls and testing banked serum and a administering a structured interview. It will be conducted within a large and on-going ARV cohort established as a collaborative project between a South African industrial conglomerate and Johns Hopkins University. [unreadable] [unreadable]
Funding Period: 2006-07-01 - 2009-06-30
more information: NIH RePORT

Top Publications

  1. ncbi Clinical implications of HIV and hepatitis B co-infection in Asia and Africa
    Christopher J Hoffmann
    Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA
    Lancet Infect Dis 7:402-9. 2007
  2. pmc Association of isoniazid preventive therapy with lower early mortality in individuals on antiretroviral therapy in a workplace programme
    Salome Charalambous
    The Aurum Institute, Johannesburg, South Africa
    AIDS 24:S5-13. 2010
  3. pmc Reducing mortality with cotrimoxazole preventive therapy at initiation of antiretroviral therapy in South Africa
    Christopher J Hoffmann
    Aurum Institute, Johannesburg, South Africa
    AIDS 24:1709-16. 2010
  4. pmc Viremia, resuppression, and time to resistance in human immunodeficiency virus (HIV) subtype C during first-line antiretroviral therapy in South Africa
    Christopher J Hoffmann
    Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, Maryland 21205, USA
    Clin Infect Dis 49:1928-35. 2009
  5. pmc Hepatitis B and long-term HIV outcomes in coinfected HAART recipients
    Christopher J Hoffmann
    Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland 21205, USA
    AIDS 23:1881-9. 2009
  6. pmc HIV suppression with stavudine 30 mg versus 40 mg in adults over 60 kg on antiretroviral therapy in South Africa
    Christopher J Hoffmann
    Aurum Institute for Health Research, Johannesburg, South Africa
    AIDS 23:1784-6. 2009
  7. pmc Hepatitis B virus infection and response to antiretroviral therapy (ART) in a South African ART program
    Christopher J Hoffmann
    Aurum Institute for Health Research and 2Toga Laboratories, Johannesburg, South Africa
    Clin Infect Dis 47:1479-85. 2008
  8. pmc Incidence and risk factors for hepatocellular carcinoma after solid organ transplantation
    Christopher J Hoffmann
    Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
    Transplantation 86:784-90. 2008
  9. pmc Antiretroviral therapy using zidovudine, lamivudine, and efavirenz in South Africa: tolerability and clinical events
    Christopher J Hoffmann
    Aurum Institute for Health Research, Johannesburg, South Africa
    AIDS 22:67-74. 2008
  10. ncbi Thyroid function abnormalities in HIV-infected patients
    Christopher J Hoffmann
    Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
    Clin Infect Dis 45:488-94. 2007

Detail Information

Publications12

  1. ncbi Clinical implications of HIV and hepatitis B co-infection in Asia and Africa
    Christopher J Hoffmann
    Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA
    Lancet Infect Dis 7:402-9. 2007
    ..This Review discusses the epidemiology, natural history, pathogenesis, and management of HIV/HBV co-infection from these areas. Topics for future research relevant to HIV/HBV co-infection in Africa and Asia are also highlighted...
  2. pmc Association of isoniazid preventive therapy with lower early mortality in individuals on antiretroviral therapy in a workplace programme
    Salome Charalambous
    The Aurum Institute, Johannesburg, South Africa
    AIDS 24:S5-13. 2010
    ..To describe the association between isoniazid preventive therapy (IPT) and mortality among individuals starting antiretroviral therapy (ART) in a workplace programme in South Africa where tuberculosis (TB) incidence is very high...
  3. pmc Reducing mortality with cotrimoxazole preventive therapy at initiation of antiretroviral therapy in South Africa
    Christopher J Hoffmann
    Aurum Institute, Johannesburg, South Africa
    AIDS 24:1709-16. 2010
    ..To assess the effectiveness of cotrimoxazole preventive therapy (CPT) among individuals with CD4 cell count above 200 cells/microl and varying WHO clinical stages in reducing mortality during combination antiretroviral therapy (cART)...
  4. pmc Viremia, resuppression, and time to resistance in human immunodeficiency virus (HIV) subtype C during first-line antiretroviral therapy in South Africa
    Christopher J Hoffmann
    Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, Maryland 21205, USA
    Clin Infect Dis 49:1928-35. 2009
    ..Episodes of viremia are common in African antiretroviral therapy (ART) programs. We sought to describe viremia, resuppression, and accumulation of resistance during first-line combination ART (cART) in South Africa...
  5. pmc Hepatitis B and long-term HIV outcomes in coinfected HAART recipients
    Christopher J Hoffmann
    Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland 21205, USA
    AIDS 23:1881-9. 2009
    ..Chronic hepatitis B (CH-B) is common among HIV-infected individuals and increases liver-related mortality in the absence of HAART. The impact of CH-B on long-term HAART outcomes has not been fully characterized...
  6. pmc HIV suppression with stavudine 30 mg versus 40 mg in adults over 60 kg on antiretroviral therapy in South Africa
    Christopher J Hoffmann
    Aurum Institute for Health Research, Johannesburg, South Africa
    AIDS 23:1784-6. 2009
    ..6). In regression modeling, including baseline HIV RNA and nonnucleoside reverse transcriptase inhibitor agent, stavudine dose remained unassociated with suppression...
  7. pmc Hepatitis B virus infection and response to antiretroviral therapy (ART) in a South African ART program
    Christopher J Hoffmann
    Aurum Institute for Health Research and 2Toga Laboratories, Johannesburg, South Africa
    Clin Infect Dis 47:1479-85. 2008
    ..We evaluated the impact of chronic hepatitis B on HIV virologic response, changes in CD4 cell count, hepatotoxicity, and mortality among Africans receiving highly active antiretroviral therapy (HAART)...
  8. pmc Incidence and risk factors for hepatocellular carcinoma after solid organ transplantation
    Christopher J Hoffmann
    Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
    Transplantation 86:784-90. 2008
    ..Solid organ transplant recipients commonly are infected with hepatitis viruses, are immunosuppressed, and have other potential hepatocellular carcinoma (HCC) risk factors...
  9. pmc Antiretroviral therapy using zidovudine, lamivudine, and efavirenz in South Africa: tolerability and clinical events
    Christopher J Hoffmann
    Aurum Institute for Health Research, Johannesburg, South Africa
    AIDS 22:67-74. 2008
    ..To describe the safety and tolerability of zidovudine, lamivudine, and efavirenz in a low-income setting...
  10. ncbi Thyroid function abnormalities in HIV-infected patients
    Christopher J Hoffmann
    Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
    Clin Infect Dis 45:488-94. 2007
    ....
  11. ncbi Hepatotoxicity in an African antiretroviral therapy cohort: the effect of tuberculosis and hepatitis B
    Christopher J Hoffmann
    Aurum Institute for Health Research, Johannesburg, South Africa
    AIDS 21:1301-8. 2007
    ..Hepatotoxicity is a significant complication of antiretroviral therapy (ART). We assessed the incidence of and risk factors for hepatotoxicity among HIV-infected individuals on ART in South Africa...
  12. pmc Prevalence and associations with hepatitis B and hepatitis C infection among HIV-infected adults in South Africa
    C J Hoffmann
    Perinatal HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa
    Int J STD AIDS 23:e10-3. 2012
    ..0% and specificity of 99.6%. In conclusion, we identified a moderate prevalence of both HBsAg and anti-HBc. Importantly, we found that subjects with HBsAg positivity had lower CD4 counts...