Treatment regimens that included Viramune (nevirapine) lowered the risk of liver fibrosis progression—especially in people who used it longest—in people coinfected with HIV and hepatitis C virus (HCV), according to a study published in the January 1 issue of Clinical Infectious Diseases.
Juan Berenguer, MD, of the HIV Infectious Disease Unit at the Hospital General Universitario “Gregorio Marañón” in Madrid, and his colleagues examined the medical records of 201 people living with both infections. Among the data reviewed were patients’ liver fibrosis scores—the severity of liver scarring, based on liver biopsy testing.
Consistent with previous studies, Berenguer’s team’s results confirmed that people taking combination antiretroviral drugs had less liver fibrosis progression than those not taking antiretrovirals. In contrast to those earlier studies, however, Berenguer’s study found that protease inhibitors were not associated with less liver fibrosis progression, but Viramune, a non-nucleoside reverse transcriptase inhibitor (NNRTI), was. In fact, the longer a person remained on Viramune treatment, the less likely they were to experience liver fibrosis progression. This effect was not seen with another commonly used NNRTI, Sustiva (efavirenz).
Berenguer concedes that the study has limitations, because it was based on reviewing patients’ records, rather than randomly assigning people to one of several drug regimens and then observing what happens. He emphasizes, however, that the study may be more accurate than previous studies because it examined the amount of time people were on individual antiretrovirals instead of simply recording whether or not people took them.
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