Raltegravir was generally well tolerated over 96 weeks of treatment in HIV-infected patients see more with and without HBV and/or HCV coinfection. The incidence of hepatobiliary adverse events ranged from 0 to 3% in patients with HBV or HCV and from 3 to 4% in those without HBV or HCV coinfection. Grade 2–4

liver enzyme elevations were observed more frequently in patients with HIV and hepatitis coinfection than in HIV-monoinfected patients, but this difference was noted in both the raltegravir and control groups. These results are consistent with two recent reports. Rachlis et al. [17] found that, among patients receiving darunavir with low-dose ritonavir in the POWER 1 and GPCR Compound Library in vitro 3 studies, patients with HBV or HCV coinfection had a higher incidence of ALT and AST elevations than those without coinfection. Vispo et al. [18] found that liver enzyme elevations occurred more frequently in HIV/HCV-coinfected patients than in HIV-monoinfected patients (P<0.001) across four antiretroviral drug classes, and that liver enzyme elevations were less frequent in patients receiving raltegravir or maraviroc than in those receiving nonnucleoside reverse transcriptase inhibitors or protease inhibitors. With regard to efficacy, we found that the antiretroviral

and immunological effects of raltegravir were similar in patients with HIV and HBV/HCV coinfection and those with HIV infection only. The studies included in these analyses were not designed to compare 3-mercaptopyruvate sulfurtransferase treatment effects in patient subgroups based on hepatitis coinfection

status. In the BENCHMRK studies, there may be relevant differences in important baseline characteristics between the subgroups because patients were not stratified by hepatitis coinfection status. In addition, the method for defining HCV infection in the BENCHMRK studies may represent a bias, as patients with HCV antibodies consist of patients with chronic HCV disease as well as successfully resolved HCV infection, which could lead to lower hepatotoxicity rates. Despite these limitations, the results of the current analyses suggest that raltegravir is generally well tolerated and efficacious for the treatment of HIV infection in patients with HBV and/or HCV coinfection, and is therefore an appropriate therapeutic alternative for these patients. Merck Sharp & Dohme Corp., a subsidiary of Merck & Co. Inc., provided financial support for the studies included in this report. “
“Long-term antibody responses to 23-valent pneumococcal polysaccharide vaccine (PPV) among HIV-infected patients receiving highly active antiretroviral therapy (HAART) are rarely investigated. Antibody responses to three pneumococcal capsular polysaccharides [Pneumococcal polysaccharide (PPS) 14, 19F and 23F] were assessed among 169 HIV-infected patients who received HAART and 23-valent PPV.