Evidence map›Paper›PMID 28222098›Full record

Observational studyPloS one2017

Multicenter study of skin rashes and hepatotoxicity in antiretroviral-naïve HIV-positive patients receiving non-nucleoside reverse-transcriptase inhibitor plus nucleoside reverse-transcriptase inhibitors in Taiwan.

Pei-Ying Wu, Chien-Yu Cheng, Chun-Eng Liu, Yi-Chien Lee, Chia-Jui Yang, Mao-Song Tsai, Shu-Hsing Cheng, Shih-Ping Lin, De-Yu Lin, Ning-Chi Wang and 4 more

Open access · goldAbstract readComparative StudyMulticenter StudyObservational Study
In one paragraph

Observational study in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 2 pooled it
2.8field-weighted citation impact, top 10% 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

15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 29 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Review
  4. Article
  5. Review
  6. Review
  7. Article
  8. Drug hypersensitivity in HIV infection.Current opinion in allergy and clinical immunology · 2019
    Review
  9. Review
  10. Article
  11. Article
  12. Article
  13. Article
  14. Article
  15. Treatment can be continued for mild cutaneous reactions associated with efavirenz.The journal of allergy and clinical immunology. In practice
    Article
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

14 authors at 12 institutions in 1 country.

Pei-Ying WuCenter of Infection Control, National Taiwan University Hospital, Taipei, Taiwan.
Chien-Yu ChengDepartment of Internal Medicine, Taoyuan General Hospital, Ministry of Health and Welfare, Tao-Yuan, Taiwan.
Chun-Eng LiuDepartment of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan.
Yi-Chien LeeDepartment of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan.
Chia-Jui YangSchool of Medicine, National Yang-Ming University, Taipei, Taiwan.
Mao-Song TsaiDepartment of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
Shu-Hsing ChengDepartment of Internal Medicine, Taoyuan General Hospital, Ministry of Health and Welfare, Tao-Yuan, Taiwan.
Shih-Ping LinDepartment of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
De-Yu LinDepartment of Internal Medicine, Tri-Service General Hospital and National Defense Medical College, Taipei, Taiwan.
Ning-Chi WangDepartment of Internal Medicine, Tri-Service General Hospital and National Defense Medical College, Taipei, Taiwan.
Yi-Chieh LeeDepartment of Internal Medicine, Lotung Poh-Ai Hospital, Medical Lo-Hsu Foundation, I-Lan, Taiwan.
Hsin-Yun SunDepartment of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Hung-Jen TangDepartment of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.
Chien-Ching HungDepartment of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Chia-Yi Christian Hospital · TWNational Taiwan University Hospital · TWChanghua Christian Hospital · TWChia Nan University of Pharmacy and Science · TWFar Eastern Memorial Hospital · TWNational Defense Medical Center · TWNational Taiwan University · TWNational Yang Ming Chiao Tung University · TWTaichung Veterans General Hospital · TWTaipei Medical University · TWTao Yuan General Hospital · TWTri-Service General Hospital · TW

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTwo nucleos(t)ide reverse-transcriptase inhibitors (NRTIs) plus 1 non-NRTI (nNRTI) remain the preferred or alternative combination antiretroviral therapy (cART) for antiretroviral-naive HIV-positive patients in Taiwan. The three most commonly used nNRTIs are nevirapine (NVP), efavirenz (EFV) and rilpivirine (RPV). This study aimed to determine the incidences of hepatotoxicity and skin rashes within 4 weeks of initiation of cART containing 1 nNRTI plus 2 NRTIs.

methodsBetween June, 2012 and November, 2015, all antiretroviral-naive HIV-positive adult patients initiating nNRTI-containing cART at 8 designated hospitals for HIV care were included in this retrospective observational study. According to the national HIV treatment guidelines, patients were assessed at baseline, 2 and 4 weeks of cART initiation, and subsequently every 8 to 12 weeks. Plasma HIV RNA load, CD4 cell count and aminotransferases were determined. The toxicity grading scale of the Division of AIDS (DAIDS) 2014 was used for reporting clinical and laboratory adverse events.

resultsDuring the 3.5-year study period, 2,341 patients initiated nNRTI-containing cART: NVP in 629 patients, EFV 1,363 patients, and RPV 349 patients. Rash of any grade occurred in 14.1% (n = 331) of the patients. In multiple logistic regression analysis, baseline CD4 cell counts (per 100-cell/μl increase, adjusted odds ratio [AOR], 1.125; 95% confidence interval [95% CI], 1.031-1.228) and use of NVP (AOR, 2.443; 95% CI, 1.816-3.286) (compared with efavirenz) were independently associated with the development of skin rashes. Among the 1,455 patients (62.2%) with aminotransferase data both at baseline and week 4, 72 (4.9%) developed grade 2 or greater hepatotoxicity. In multiple logistic regression analysis, presence of antibody for hepatitis C virus (HCV) (AOR, 2.865; 95% CI, 1.439-5.704) or hepatitis B surface antigen (AOR, 2.397; 95% CI, 1.150-4.997), and development of skin rashes (AOR, 2.811; 95% CI, 1.051-7.521) were independently associated with the development of hepatotoxicity.

conclusionsThe baseline CD4 cell counts and use of NVP were associated with increased risk of skin rashes, while hepatotoxicity was independently associated with HCV or hepatitis B virus coinfection, and development of skin rashes in antiretroviral-naïve HIV-positive Taiwanese patients within 4 weeks of initiation of nNRTI-containing regimens.

Indexed as

AdultAlanine TransaminaseAnti-HIV AgentsAspartate AminotransferasesCD4 Lymphocyte CountChemical and Drug Induced Liver InjuryDisease ManagementDrug EruptionsDrug Therapy, CombinationFemaleHIV InfectionsHumansIncidenceMaleMiddle AgedNucleosidesAlanine TransaminaseAnti-HIV AgentsAspartate AminotransferasesNucleosidesReverse Transcriptase InhibitorsRNA, Viral

Identifiers

PMID28222098
PMCPMC5319792
OpenAlexW2590792679

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.