didanosine and Hyperplasia

Nodular regenerative hyperplasia (NRH) leading to non-cirrhotic portal hypertension has been described in HIV-infected patients and has been linked to didanosine. The relation between NRH and other antiretrovirals remains unclear.. A case-control study was performed in 13 patients with NRH and 78 controls matched for time of inclusion, baseline CD4, and duration of follow-up. Univariate and multivariate conditional logistic regression analyses were performed.. Control patients and patients with NRH were similar at baseline regarding demographics and biological data with the exception of older age for patients with NRH (43.9 vs. 33.5 years, p=0.044). At the time of NRH diagnosis, cases had a lower CD4 count (327 vs. 468/mm(3), p=0.013), a similar CD4 percentage (24 vs. 26.2%, p=0.7), a lower platelet count (169 vs. 228 giga/L, p=0.003) and a higher AST level (33 vs. 26 IU/L, p=0.001) than controls. Univariate analysis demonstrated that patients with NRH had been exposed longer than controls to didanosine, stavudine, tenofovir, didanosine+stavudine, and didanosine+tenofovir. The age at baseline [OR 2.2 (1.0-5.0) per 10 years, p=0.053] and didanosine+stavudine cumulative exposure [OR 3.7 (1.4-10.2) per year, p=0.011] were independently associated with NRH. The age at baseline [OR 2.3 (1.0-5.3) per 10 years, p=0.045], cumulative exposure to didanosine [OR 1.4 (1.1-1.9) per year, p=0.023] and to tenofovir [OR 1.7 (1.0-2.8) per year, p=0.04] were independently associated with NRH when didanosine+stavudine exposure was excluded from the model.. NRH in HIV-infected patients seems strongly related to age and the cumulative exposure to didanosine+stavudine, didanosine, and stavudine.

Topics: Adenine; Adult; Anti-HIV Agents; Antiretroviral Therapy, Highly Active; Case-Control Studies; Didanosine; Female; HIV Infections; Humans; Hyperplasia; Hypertension, Portal; Liver; Liver Regeneration; Male; Middle Aged; Organophosphonates; Reverse Transcriptase Inhibitors; Stavudine; Tenofovir

The authors describe an HIV-positive patient with nodular regenerative hyperplasia of the liver with non-cirrhotic portal hypertension. Despite stopping the culprit drug, didanosine, the radiologic changes persisted for years. When evaluating liver pathologies, antiretroviral drugs must be included in the differential diagnosis, even when they have been stopped years ago.

Topics: Anti-HIV Agents; Didanosine; HIV Infections; Humans; Hyperplasia; Hypertension, Portal; Liver; Male; Middle Aged; Radiography; Time Factors

Topics: Adult; Anti-Retroviral Agents; Didanosine; Esophageal and Gastric Varices; HIV Infections; HIV-1; Humans; Hyperplasia; Hypertension, Portal; Liver; Liver Diseases; Liver Regeneration; Middle Aged

Topics: Anti-Retroviral Agents; Antiretroviral Therapy, Highly Active; Chemical and Drug Induced Liver Injury; Didanosine; Female; HIV Infections; HIV-1; Humans; Hyperplasia; Liver; Liver Diseases; Liver Regeneration; Middle Aged; Nevirapine; Zidovudine

Cystic benign lymphoepithelial lesion, a previously rare lesion of the parotid gland characterized by multiple cysts accompanied by marked lymphoid hyperplasia, is increasingly reported in patients with human immunodeficiency virus infection. The case of a 59-year-old man without identifiable risk factors for the acquired immunodeficiency syndrome is presented, in whom the development of cystic benign lymphoepithelial lesions led to the diagnosis of the underlying human immunodeficiency virus infection. The lymphoepithelial lesion remained unchanged for 8 years. When chemotherapy was instituted for abdominal non-Hodgkin's lymphoma all cystic lesions resolved completely. This previously undescribed phenomenon strongly supports the concept that the development of the cysts is secondary to the mechanical obstruction of salivary ducts caused by lymphoid hyperplasia and not due to true de novo cyst formation.

Topics: Antineoplastic Combined Chemotherapy Protocols; Antiviral Agents; Cyclophosphamide; Cysts; Didanosine; Doxorubicin; Fatal Outcome; HIV Infections; Humans; Hyperplasia; Lymphoma, Non-Hodgkin; Male; Middle Aged; Parotid Diseases; Prednisone; Vincristine; Zidovudine