Evidence map›Paper›PMID 27431048›Full record

ArticleJournal of substance abuse treatment2016

Hepatic Safety of Buprenorphine in HIV-Infected and Uninfected Patients With Opioid Use Disorder: The Role of HCV-Infection.

Jeanette M Tetrault, Janet P Tate, E Jennifer Edelman, Adam J Gordon, Vincent Lo Re, Joseph K Lim, David Rimland, Joseph Goulet, Stephen Crystal, Julie R Gaither and 6 more

Abstract read
In one paragraph

Article in Journal of substance abuse treatment, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact, top 95% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 9 institutions in 2 countries.

Jeanette M TetraultDepartment of Internal Medicine, Yale University School of Medicine, New Haven, CT. Electronic address: jeanette.tetrault@yale.edu.
Janet P TateDepartment of Internal Medicine, Yale University School of Medicine, New Haven, CT; VA Connecticut Health Care System, West Haven, CT.
E Jennifer EdelmanDepartment of Internal Medicine, Yale University School of Medicine, New Haven, CT.
Adam J GordonVA Pittsburgh Healthcare System and University of Pittsburgh, Pittsburgh, PA.
Vincent Lo ReUniversity of Pennsylvania School of Medicine, Philadelphia, PA.
Joseph K LimDepartment of Internal Medicine, Yale University School of Medicine, New Haven, CT.
David RimlandVA Medical Center, Atlanta, GA; Emory University School of Medicine, Atlanta, GA.
Joseph GouletVA Connecticut Health Care System, West Haven, CT; Department of Psychiatry, Yale University School of Medicine, New Haven, CT.
Stephen CrystalCenter for Health Services Research, Institute for Health, Rutgers University.
Julie R GaitherCenter for Interdisciplinary Research on AIDS, Yale University School of Public Health, New Haven, CT.
Cynthia L GibertVA Medical Center Washington DC; George Washington University School of Medicine and Health Sciences, Washington, DC.
Maria C Rodriguez-BarradasMichael E. DeBakey VA Medical Center and Baylor College School of Medicine, Houston, TX.
Lynn E FiellinDepartment of Internal Medicine, Yale University School of Medicine, New Haven, CT.
Kendall BryantNational Institute of Alcohol Abuse and Alcoholism, Bethesda, MD.
Amy C JusticeDepartment of Internal Medicine, Yale University School of Medicine, New Haven, CT; VA Connecticut Health Care System, West Haven, CT; Center for Interdisciplinary Research on AIDS, Yale University School of Public Health, New Haven, CT.
David A FiellinDepartment of Internal Medicine, Yale University School of Medicine, New Haven, CT; Center for Interdisciplinary Research on AIDS, Yale University School of Public Health, New Haven, CT.
Yale University · USEmory University · USMichael E. DeBakey VA Medical Center · USNational Institute on Alcohol Abuse and Alcoholism · USRutgers Sexual and Reproductive Health and Rights · NLUniversity of Pennsylvania · USUniversity of Pittsburgh · USVA Connecticut Healthcare System · USWashington DC VA Medical Center · US

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
Yale Liver CenterP30DK034989 · NIDDK · YALE UNIVERSITY · PI YASUKO IWAKIRI · 1986 to 2026
$31.1M
Alcohol Associated Outcomes Among HIV+/- Aging VeteransU10AA013566 · NIAAA · YALE UNIVERSITY · PI JUSTICE, AMY CAROLINE · 2006 to 2010
$12.7M
Alcohol and Multisubstance Use in the Veterans Aging Cohort StudyU01AA020790 · NIAAA · YALE UNIVERSITY · PI JUSTICE, AMY CAROLINE · 2011 to 2020
$7.7M
Sex Disparities in Overall Response to ART Among HIV Infected IndividualsU24AA020794 · NIAAA · YALE UNIVERSITY · PI JUSTICE, AMY CAROLINE · 2011 to 2020
$5.5M
Center for Education and Research on Mental Health TherapeuticsU19HS021112 · AHRQ · RUTGERS, THE STATE UNIV OF N.J. · PI CRYSTAL, STEPHEN · 2011 to 2015
$3.9M
Translational Research on Alcohol, Immunodeficiency, and Aging In COMpAAASU24AA022001 · NIAAA · YALE UNIVERSITY · PI BRANDT, CYNTHIA A. · 2012 to 2020
$3.2M
Clinical Prediction of Hepatotoxicity & Comparative Hepatic Safety of MedicationsR01HS018372 · AHRQ · UNIVERSITY OF PENNSYLVANIA · PI LO RE, VINCENT · 2010 to 2014
$2.5M
AHRQ HHS R01 HS018372AHRQ HHS U19 HS021112NCATS NIH HHS UL1 TR001863NIAAA NIH HHS U01 AA020790NIAAA NIH HHS U10 AA013566NIAAA NIH HHS U24 AA020794NIAAA NIH HHS U24 AA022001NIDDK NIH HHS P30 DK034989
6 · The paper itself

Abstract

introductionIndividuals with HIV and hepatitis C (HCV) infection, alcohol use disorder, or who are prescribed potentially hepatotoxic medications may be at increased risk for buprenorphine (BUP) associated hepatotoxicity. MATERIALS AND

methodsWe examined a cohort of HIV-infected and uninfected patients receiving an initial BUP prescription between 2003 and 2012. We compared changes in alanine and aspartate aminotransferases (ALT and AST) and total bilirubin (TB) stratified by HIV status. We identified cases of liver enzyme elevation (LEE), TB elevation (TBE), and conducted chart review to assess for cases of drug induced liver injury (DILI) and death. We examined associations between age, sex, race, HIV-infection, HCV-infection, alcohol use disorder, and prescription of other potentially heptatotoxic medications with the composite endpoint of LEE, TBE, and DILI.

resultsOf 666 patients prescribed BUP, 36% were HIV-infected, 98% were male, 60% had RNA-confirmed HCV infection, 50% had a recent diagnosis of alcohol use disorder, and 64% were prescribed other potentially hepatotoxic medications. No clinically significant changes were observed in median ALT, AST and TB and these changes did not differ between HIV-infected and uninfected patients. Compared with uninfected patients, HIV-infected (OR 7.3, 95% CI 2.1-26.1, p=0.002), HCV-infected (OR 4.9 95% CI 1.6-15.2, p=0.007) or HIV/HCV co-infected patients (OR 6.9, 95%CI 2.1-22.2, p=0.001) were more likely to have the composite endpoint of LEE, TB elevation or DILI, in analyses that excluded 60 patients with evidence of pre-existing liver injury. 31 patients had LEE, 14/187 HIV-infected and 17/340 uninfected (p=0.25); 11 had TBE, including 9/186 HIV-infected and 2/329 uninfected (p=0.002); 8 experienced DILI, 4/202 HIV-infected and 4/204 uninfected (p=0.45). There were no significant associations with alcohol use disorder or prescription of other potentially hepatotoxic medications after adjustment for HIV/HCV status.

conclusionsLiver enzymes and TB are rarely elevated in HIV-infected and uninfected patients receiving BUP. Risk of hepatotoxicity was greater in individuals infected with HIV, HCV, or HIV/HCV co-infection, who may benefit from increased monitoring.

Indexed as

Alanine TransaminaseAspartate AminotransferasesBuprenorphineChemical and Drug Induced Liver InjuryCohort StudiesCoinfectionFemaleHepatitis CHIV InfectionsHumansMaleMiddle AgedOpiate Substitution TreatmentOpioid-Related DisordersRisk FactorsAlanine TransaminaseAspartate AminotransferasesBuprenorphineBuprenorphineDrug induced liver injuryHepatitis CHIV

Identifiers

PMID27431048
PMCPMC4976086
OpenAlexW2412093456

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.