Short Communication: Nelfinavir in HIV-HCV Coinfected Patients: A 24-Month Follow-Up in a Cohort of 82 Patients

Abstract

This retrospective and longitudinal study evaluated the long-term hepatic tolerance of a nelfinavir (NFV)–antiretroviral combined regimen in 82 patients of the HCV-HIV Cohort of CISIH-Sud of Marseilles. Follow-up data (liver enzyme levels, CD4 cell count, HIV viral load, and metabolic parameters) of patients treated with NFV on inclusion or during the follow-up of the cohort were analyzed under treatment over 24 months. Comparisons were performed with X ² or Kruskal–Wallis tests. At baseline (n = 82), the median exposure to NFV was 4.1 months; 58 patients received NFV combined with NRTI and 24 with NNRTI. The median CD4 cell count was 337/mm³ [interquartile range (IR): 216–480) and 39.7% had an undetectable HIV RNA level. Qualitative HCV PCR was positive in 91% of the patients and 19/51 patients with liver biopsy were F3–F4. Median alanine and aspartate aminotransferase (ALAT, ASAT), γ-glutamyltransferase (GT), and alkaline phosphatase(ALP) were 46 UI/liter (IR: 36–76), 55 UI/liter (IR: 32–97), 97 UI/liter (IR: 50–194), and 88 UI/liter(IR: 72-104), respectively, with 76% of the patients with ALAT/ASAT grade <2. Median follow-up was 23 months (IR: 13.8–37). No significant difference was observed in the distribution of ALAT, ASAT, GT, and ALP as well as of ALAT/ASAT grades over the 24-month study period. Patients treated with NFV + NNRTI had significantly higher GT and ALP levels at baseline with no significant increase during follow-up. Cholesterol, triglyceride, and glycemia distributions remained stable over time. In conclusion, this study showed a good hepatic and metabolic tolerance of a long-term NFV-combined regimen in HIV-HCV coinfected patients.