Management of Hepatotoxicity in HIV-Infected Patients Treated withCombined Antiretroviral Therapy (cART): A Retrospective Cohort Study inTianjin, China

Background: Liver diseases are among the most frequent causes of non-AIDS-related deaths in human immunodeficiency virus (HIV)-infected patients due to hepatitis B or C virus co-infections, and/or the toxicity of longterm treatment of some antiviral drugs. There are few cohort studies reported in China. Methods: All data from the clinic HIV/AIDS patients in the database of Tianjin Second People’s Hospital, a branch of the National Free Antiretroviral Treatment Program database, from April 1, 2010 to March 31, 2016 were retrospectively assessed and analyzed. Results: We analyzed 2270 HIV-positive, hepatitis B virus (HBV-), hepatitis C virus (HCV-) negative patients, who received cART and followed for 13334.8 person-years. A total of 67 patients (3.0%, or 5.0 per 1000 person-years) died of non-liver-related causes. The incidence of liver-related deaths in persons without HCV or HBV co-infections was zero percent during follow-up. Only 30 cases (1.3% or 2.2 per 1000 person-years) developed hepatotoxicity, but liver function of these patients improved after changing cART regimens. Conclusion: cART-related hepatotoxicity can be well-controlled and managed by modifying the therapeutic regimens. Liver-related mortality in HIV-positive, HBV-, HCV-negative patients is currently zero percent in Tianjin, China.