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  • Poster presentation
  • Open Access

Hepatic safety of tipranavir/ritonavir (TPV/r)-based antiretroviral therapy: effect of hepatitis virus co-infection and baseline liver fibrosis

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Journal of the International AIDS Society200811 (Suppl 1) :P141

  • Published:


  • Liver Fibrosis
  • Transaminase Elevation
  • Advanced Fibrosis
  • Clinical Cohort
  • Real Life Condition

Purpose of the study

Data on the hepatic safety of TPV/r comes mostly from clinical trials. The liver tolerability of TPV/r in real life conditions of use could be different. However, there are little data on this issue from clinical cohorts. Because of these, we evaluated the incidence and risk factors of severe liver events among HIV-infected patients treated with drug combinations including TPV/r.


150 patients were selected because they started a regimen that included TPV/r (500/200 mg BID), and had clinical visits at least every 3 months. Patients who discontinued TPV/r before their first visit were included.

Summary of results

Twelve (8%) individuals developed grade ≥3 transaminase elevation (G ≥ 3TE). Nine (6%) patients discontinued TPV/r due to liver events. Six (8.6%) of 70 HCV-coinfected patients and six (7.5%) of 80 subjects without HCV co-infection developed G ≥ 3TE (p = 1). Liver fibrosis was evaluable in 48 (63%) of 76 individuals with HBV and/or HCV infection. Four (13%) of 30 subjects with moderate-to-severe fibrosis and none of 18 with mild fibrosis showed G ≥ 3TE (p = 0.3). None of nine patients with cirrhosis showed G ≥ 3TE.


Liver tolerability of TPV/r was generally good in a cohort of patients with a high proportion of HCV co-infection, including subjects with advanced fibrosis. Monitoring of liver enzymes was not different for co-infected patients. Thus, more frequent blood testing does not seem warranted for these patients.

Authors’ Affiliations

Hospital Univ. de Valme, Seville, Spain
Hospital Univ. Carlos de Haya, Malaga, Spain
Hospital Univ. Reina Sofía, Cordoba, Spain
Hospital Univ. Virgen del Rocío, Seville, Spain
Hospital Univ. Virgen de la Victoria, Malaga, Spain
Hospital General Univ. de Alicante, Alicante, Spain
Hospital Univ. Virgen Macarena, Seville, Spain
Hospital Univ. San Cecilio, Granada, Spain
Hospital Univ. Virgen de las Nieves, Granada, Spain


© Macias et al; licensee BioMed Central Ltd. 2008

This article is published under license to BioMed Central Ltd.