Risk factors analysis on drug-induced liver injury in acquired immunodeficiency syndrome patients treated with compound sulfamethoxazole
AIM To explore the risk factors of drug-induced liver injury(DILI)of compound sulfamethoxazole(sulfamethoxazole-trimethoprim,SMZ-TMP)in acquired immunodeficiency syndrome(AIDS)patients and provide reference for clinical pharmacovigilance and rational drug use.METHODS The data of AIDS patients treated with SMZ-TMP in our hospital from December 2020 to December 2022 were collected retrospectively.The general information of patients with DILI after taking SMZ-TMP was compared with that of patients without DILI,and binary logistic regression equation was constructed to screen out the risk factors of DILI in AIDS patients induced by SMZ-TMP.RESULTS Totally 271 AIDS patients were involved,and 29 patients had DILI,all of whom were male.Among them,27 patients were of hepatocellular injury pattern and 2 patients were of cholestatic injury pattern.All DILI patients were cured or improved after symptomatic treatment.Relevant factor analysis showed that,allergy history(OR=15.334,95％CI:3.147 to 74.710),no receiving antiviral treatment or tenofovir+lamivudine+lopinavir/ritonavir(TDF+3TC+LPV/r)regimen(OR=56.123,95％CI:10.797 to 291.719),daily dose of SMZ-TMP ≥ 12 tablets(OR=52.809,95％CI:9.894 to 281.868),alanine transaminase(ALT)≥ 23 U·L-1(OR=18.514,95％CI:3.993 to 85.843),CD4+T cell ≤ 110·μL-1(OR=40.586,95％CI:6.625 to 248.634),and CD8+T cell ≤ 920·μL-1(OR=135.978,95％CI:11.190 to 1 652.303)can increase the risk of SMZ-TMP related DILI in AIDS patients(P＜0.05).CONCLUSION The incidence of SMZ-TMP related DILI is relatively high in AIDS patients.Allergy history,selection of antiviral treatment regimens,dose of SMZ-TMP,ALT level,and CD4+and CD8+T lymphocyte counts are the independent risk factors for SMZ-TMP related DILI in AIDS patients.Monitoring of high-risk population should be strengthened and early intervention measures should be taken.
万方数据
维普
