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Better control of liver enzymes saves lives of HIV patients, says University Of Pittsburgh

,700 participants from two observational studies: Collaborations in HIV Research U.S. (CHORUS), composed largely of white men who contracted HIV from homosexual activity, and women who contracted HIV from heterosexual activity or intravenous drug use; and the Veterans Aging Cohort Study (VACS), composed mainly of African American men who contracted HIV from heterosexual activity or intravenous drug use.

Study participants with mild to moderate elevations had an increased risk of death that was 1.73 times the risk of those with mid-range normal enzyme levels. Those with two or more times the normal enzyme levels had a 5.06 increased risk of death. Results were consistent in both the CHORUS and VACS cohorts.

"The fact that the findings were similar in two very different cohorts suggests that these results apply to all HIV patients," said Dr. Justice. "Furthermore, the fact that the most common current cause of death among people with HIV is liver failure suggests that liver injury may be a major limiting factor in the effectiveness of current HIV treatment."

In a related poster on display at the conference, Dr. Justice and colleagues relay findings from a study showing that incidence of liver cancer among HIV-positive veterans since the advent of HAART is nearly twice as high as it is for HIV-negative veterans. The researchers indicate that possible reasons for the increase may include drug toxicity and viral hepatitis.

"Chronic viral hepatitis is known to substantially increase the risk of liver cancer," said Dr. Justice. "Additional research must be done to determine whether HAART exacerbates this risk or only helps HIV-positive patients live long enough to suffer the consequences of other chronic diseases such as cancer."


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Contact: Kathryn Duda
412-624-2607
University of Pittsburgh Medical Center
8-Jul-2002


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