DDI and liver tests in HIV-1 seropositive haemophiliacs

Many patients with haemophilia who are HIV-1 seropositive are co-infected with the hepatitis C virus with variable degrees of underlying liver disease. To evaluate whether the use of the antiretroviral agent Dideoxyinosine (DDI) causes worsening of hepatic dysfunction as measured by liver enzyme tests, we reviewed our cohort of patients previously treated with monotherapy with Zidovudine (AZT) and subsequently changed to DDI. Seventeen patients (median age: 34 years, median absolute CD4 lymphocyte cell count: 86 cells μL(-1) ) were included in this study. None had coincident use of other hepatotoxic agents. The median duration of treatment with AZT and DDI was 18 and 15 months, respectively. There was no significant change in liver function tests with the use of DDI and no development of clinical signs of hepatotoxicity. Neither duration of treatment, absolute CD4 lymphocyte cell count, pre-existing elevation of baseline aminotransferase levels nor the use of Pneumocystis carinii prophylaxis therapy resulted in further elevation of liver function tests. Monotherapy with DDI was well tolerated in this cohort of HIV-1-seropositive haemophiliacs with coincident hepatitis C infection.