Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 7, 2016; 22(1): 349-360
Published online Jan 7, 2016. doi: 10.3748/wjg.v22.i1.349
Combination antiretroviral studies for patients with primary biliary cirrhosis
Ellina Lytvyak, Aldo J Montano-Loza, Andrew L Mason
Ellina Lytvyak, Aldo J Montano-Loza, Andrew L Mason, Division of Gastroenterology and Hepatology, University of Alberta, Edmonton T6G 2E1, Alberta, Canada
Author contributions: Both Lytvyak E and Mason AL wrote the manuscript; Lytvyak E analyzed and interpreted the data, edited the manuscript; Mason AL conceived the studies, contributed new analytic tools, analyzed and interpreted the data; all the authors contributed to this manuscript.
Supported by Research support from Alberta Innovates Health Solutions, Canadian Institutes for Health Research (to Mason AL, MOP 97798); and Canadian Liver Foundation relevant to this manuscript.
Conflict-of-interest statement: All authors have no conflict of interest to declare. Abbott and Gilead have provided antiviral therapy for patients with primary biliary cirrhosis participating in clinical trials.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Andrew L Mason, MBBS, FRCPI, Professor of Medicine, Division of Gastroenterology and Hepatology, University of Alberta, 7-142 Katz Group Rexall Centre, Edmonton T6G 2E1, Alberta, Canada.
Telephone: +1-780-4928176 Fax: +1-780-4921655
Received: June 8, 2015
Peer-review started: June 10, 2015
First decision: July 14, 2015
Revised: August 12, 2015
Accepted: November 9, 2015
Article in press: November 9, 2015
Published online: January 7, 2016
Core Tip

Core tip: Early experience with antiretroviral therapy in primary biliary cirrhosis (PBC) patients strongly suggests that reverse transcriptase inhibitors alone lack efficacy to provide sustained and clinically meaningful biochemical responses. In contrast, combination antiretroviral therapy with human immunodeficiency virus protease inhibitors have been linked with robust and long-lived biochemical responses in PBC patients capable of tolerating the therapy. The use of digital droplet polymerase chain reaction has markedly improved the sensitivity of viral detection in peripheral blood and should enable studies to link reduction in viral load with improvements in hepatic biochemistry and histology.