Hepatotoxicity of antiretrovirals: Incidence, mechanisms and management

Prevalence of adverse drug reactions in adult patients on anti-retrovirals at Kenyatta National Hospital, Comprehensive Care Centre

“…However, though several antiretrovirals have been reported to cause fatal acute hepatitis, most often they only cause an asymptomatic elevation of ALT (23). In our study, hepatoxicity occurred in approximately 4% of patients, which is higher rate than among several cohorts in resource-limited settings.…”

An Update on Drug-induced Liver Injury

“…68 Overlapping toxicities are a major cause with contributions from both drug-drug and drug-disease interaction. 69,70 Diminished reserves of glutathione are cited as a predisposing factor. Drugs associated with an increased risk for DILI include zidovudine, stavudine, nevirapine, efavirenz, abacavir and others.…”

“…Drugs associated with an increased risk for DILI include zidovudine, stavudine, nevirapine, efavirenz, abacavir and others. 68,69 Both nevirapine and abacavir produce immunoallergic or hypersensitivity reaction with features of skin rashes, fever, lymphadenopathy and eosinophilia. The immune mediated hypersensitivity reaction associated with nevirapine usually tends to occur within 6 weeks after initiation of treatment and presents with skin rashes and hepatitis.…”

Pérdida de seguimiento y factores asociados en pacientes inscritos en el programa de HIV/sida del Hospital Universitario San Ignacio, Colombia, 2012-2013

“…En el manejo a largo plazo del paciente con HIV, han surgido retos adicionales como la toxicidad de los medicamentos (4,5), el fracaso del tratamiento debido a un cumplimiento inadecuado (6,7), la resistencia a los medicamentos antirretrovirales (8) con el consecuente cambio en el esquema de tratamiento, y un incremento en la morbilidad y la mortalidad no asociadas al HIV (9,10). Los pacientes con HIV requieren un seguimiento clínico prolongado para vigilar la progresión de la enfermedad y determinar el momento oportuno para iniciar el tratamiento y para evaluar la respuesta terapéutica, el cumplimiento del tratamiento antirretroviral y los efectos secundarios, y para abordar los aspectos de salud sexual y las necesidades de prevención del HIV (11).…”