Table 4.
Risk Factors for Liver Aminotransferases >200 U/L and Severe Acute Liver Injury Among HIV-Infected Individuals Who Were New Initiators of Antiretroviral Therapy Within Kaiser Permanente Northern California (2004–2010) and the Veterans Aging Cohort Study (2004–2012)
| Characteristic | Unadjusted HR of Liver Aminotransferases >200 U/L (95% CI) | Adjusted HRa of Liver Aminotransferases >200 U/L (95% CI) | Unadjusted HRb of Severe ALI (95% CI) |
|---|---|---|---|
| Age | |||
| 18–50 years | Reference | Reference | Reference |
| ≥50 years | 1.25 (0.95–1.64) | 0.89 (0.66–1.19) | 2.66 (1.25–5.69) |
| Sex | |||
| Male | Reference | Reference | Reference |
| Female | 0.87 (0.45–1.70) | 1.11 (0.56–2.21) | 2.10 (0.64–6.93) |
| Race | |||
| Non-Black | Reference | Reference | Reference |
| Black | 1.17 (0.89–1.53) | 0.88 (0.66–1.19) | 1.44 (0.70–2.96) |
| Body Mass Index | |||
| <30 kg/m2 | Reference | Reference | Reference |
| ≥30 kg/m2 | 0.92 (0.64–1.32) | 0.93 (0.64–1.35) | 0.90 (0.34–2.35) |
| Viral Hepatitis Coinfection | |||
| Uninfected | Reference | Reference | Reference |
| HCV or HBV-infected | 5.26 (4.00–6.93) | 4.21 (3.10–5.72) | 4.64 (2.26–9.51) |
| History of Alcohol Dependence/Abuse | |||
| No | Reference | Reference | Reference |
| Yes | 1.63 (1.22–2.19) | 1.10 (0.81–1.50) | 1.47 (0.67–3.20) |
| Diabetes Mellitus | |||
| No | Reference | Reference | Reference |
| Yes | 1.46 (0.97–2.21) | 1.22 (0.80–1.87) | 2.00 (0.77–5.23) |
| Heart Failure | |||
| No | Reference | Reference | Reference |
| Yes | 0.86 (0.27–2.68) | 0.76 (0.24–2.42) | 6.26 (1.90–20.66) |
| HIV RNA (per log10 copies/mL) | 0.95 (0.80–1.12) | 0.90 (0.75–1.08) | 1.82 (1.10–3.01) |
| CD4 cell count | |||
| ≥500 cells/mm3 | Reference | Reference | Reference |
| 200–500 cells/mm3 | 1.39 (0.78–2.48) | 1.38 (0.76–2.48) | 0.65 (0.14–3.14) |
| <200 cells/mm3 | 1.73 (0.96–3.10) | 1.68 (0.91–3.10) | 2.62 (0.61–11.16) |
| Baseline ALT | |||
| ALT <40 IU/mL | Reference | Reference | Reference |
| ALT ≥40 IU/mL | 3.38 (2.55–4.49) | 2.49 (1.85–3.34) | 1.92 (0.93–3.96) |
Abbreviations: ALI, acute liver injury; ALT, alanine aminotransferase; CI, confidence interval; HBV, hepatitis B virus; HCV, hepatitis C virus; HIV, human immunodeficiency virus; HR, hazard ratio; RNA, ribonucleic acid.
aModel adjusted for all covariates shown as well as calendar year of antiretroviral therapy initiation and data source.
bDue to the low number of severe ALI events, adjusted analyses could not be performed.