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Randomized trials have shown a low incidence of severe hepatotoxicity with lopinavir/ritonavir. Most of those trials, however, included only a limited number of patients coinfected with hepatotropic viruses, most notably hepatitis C (HCV). Previous prospective cohort studies have documented higher rates of clinically significant liver-enzyme elevations in HCV-coinfected patients taking lopinavir/r, but further studies are needed to delineate the exact risk.
In Spain, researchers conducted a retrospective, multicenter cohort study among 388 HIV-infected patients who had started lopinavir/r between January 2001 and June 2005 (median age, 39; 77% male). Sixty-one percent of patients had concurrent HCV infection. Patients were followed for a med…