Pharmacotherapy · 2001
Retrospective evaluation of the effect of valproate therapy on transaminase elevations in patients with hepatitis C.
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Lott R S, Helmboldt K M, Madaras-Kelly K J
Аннотация
STUDY OBJECTIVE: To evaluate whether a relationship exists between valproate treatment and transaminase elevations in patients who are positive for hepatitis C virus (HCV).
DESIGN: Retrospective medical record review.
SETTING: Veterans affairs medical center.
PATIENTS: A total of 214 HCV-positive patients; 28 were treated with valproate (study group), 186 were not (control group).
INTERVENTION: Demographic characteristics; valproate treatment histories; plasma concentrations of alanine aminotransferase (ALT) and aspartate aminotransferase (AST), albumin, and bilirubin; and exposure to other potentially hepatotoxic drugs, including probable alcohol abuse, were evaluated.
MEASUREMENTS AND MAIN RESULTS: Hepatotoxicity was staged by comparing maximum ALT and AST values against upper limits of normal or patients' mean elevated baseline ALT and AST values. Data were analyzed using a logistic regression model. Control patients and those with longer durations of HCV were more likely (p<0.0171 and p<0.0142, respectively) to exhibit higher stages of hepatotoxicity. More valproate-treated patients were exposed to other potential hepatotoxins at the time of peak transaminase elevations (50% vs 39%, p<0.005), whereas more control patients received two or more potential hepatotoxins (13% vs 4%, p<0.00005).
CONCLUSION: Valproate treatment, either alone or in the presence of other potential hepatotoxins, does not appear to be related to increased transaminase elevations in patients with HCV
DESIGN: Retrospective medical record review.
SETTING: Veterans affairs medical center.
PATIENTS: A total of 214 HCV-positive patients; 28 were treated with valproate (study group), 186 were not (control group).
INTERVENTION: Demographic characteristics; valproate treatment histories; plasma concentrations of alanine aminotransferase (ALT) and aspartate aminotransferase (AST), albumin, and bilirubin; and exposure to other potentially hepatotoxic drugs, including probable alcohol abuse, were evaluated.
MEASUREMENTS AND MAIN RESULTS: Hepatotoxicity was staged by comparing maximum ALT and AST values against upper limits of normal or patients' mean elevated baseline ALT and AST values. Data were analyzed using a logistic regression model. Control patients and those with longer durations of HCV were more likely (p<0.0171 and p<0.0142, respectively) to exhibit higher stages of hepatotoxicity. More valproate-treated patients were exposed to other potential hepatotoxins at the time of peak transaminase elevations (50% vs 39%, p<0.005), whereas more control patients received two or more potential hepatotoxins (13% vs 4%, p<0.00005).
CONCLUSION: Valproate treatment, either alone or in the presence of other potential hepatotoxins, does not appear to be related to increased transaminase elevations in patients with HCV