Hepatotoxicity associated with nevirapine or efavirenz-containing antiretroviral therapy: Role of hepatitis C and B infections

• DOI: 10.1053/jhep.2002.30319
• Publication Date: 2002-08-25T03:46:10Z
• Authors: Mark S. Sulkowski; David L. Thomas; Shruti H. Mehta; Richard E. Chaisson; Richard D. Moore
• Keywords: Nevirapine; Efavirenz; Hepatitis C; Hepatitis B

Hepatologists are frequently asked to evaluate human immunodeficiency virus (HIV)-infected patients with abnormal liver enzymes and assess the causal role of medications, such as antiretroviral drugs. Recently, use HIV-1 specific non-nucleoside reverse transcriptase inhibitors (NNRTIs), including nevirapine (NVP) efavirenz (EFV), has been associated severe hepatic injury. We prospectively studied incidence hepatotoxicity (grade 3 or 4 change in alanine aspartate transaminase levels) among 568 receiving NNRTI-containing therapy, 312 256 prescribed EFV NVP, respectively. Hepatitis C (HCV) hepatitis B (HBV) were detected 43% 7.7% patients, Severe was observed 15.6% NVP 8.0% those EFV, but only 32% 50% EFV-associated episodes during first 12-weeks therapy. The risk significantly greater persons chronic viral (69% cases) concurrent protease (PIs) (82% cases). Nonetheless, 84% HCV HBV did not experience hepatotoxicity. occurs throughout course NNRTI therapy is more common nevirapine, coinfected HBV, coadministered inhibitors.