Antiretroviral and Liver Injury

• Antiretroviral drug-related liver injury is a common cause of morbidity, mortality and treatment discontinuation in HIV-infected patients,
• Antiretroviral drug-related liver injury is defined by elevations in liver enzymes in serum, with ALT characteristically greater than AST.
• After initiating HAART, the reported incidence of severe liver toxicity ranges from 2 to 18%.
• Antiretroviral drug-related liver injury, especially severe toxicity, is clearly more frequent in HIV-infected patients with underlying chronic HBV and/or HCV infection.
• Other predisposing factors are alcohol, consumption of ecstasy and cocaine; risk of liver injury is increased in those patients with transaminases elevations prior to initiating HAART

Potential and common Biochemical features

Drug related Liver Injury

References:

1. Liver Disease and Cirrhosis PRIMARY CARE OF VETERANS WITH HIV Organ Systems and Metabolic. April 2009; Last reviewed/updated: October 28, 2011
2. Soriano V. et al. Antiretroviral drugs and liver injury. AIDS. 2008 Jan 2;22(1):1-13.
3. Antiretroviral Drugs and Liver Injury. http://www.medscape.com/viewarticle/568415_2