Antiretroviral and anti-hepatitis C virus direct-acting antiviral-related hepatotoxicity

Clin Liver Dis. 2013 Nov;17(4):657-70, ix. doi: 10.1016/j.cld.2013.07.007. Epub 2013 Sep 4.

Abstract

Antiretroviral-related hepatotoxicity occurs commonly in patients with human immunodeficiency virus (HIV). Liver injury ranges from unconjugated hyperbilirubinemia and nodular regenerative hyperplasia to lactic acidosis and toxic hepatitis. Effective antiretroviral therapy has changed coinfected patients' primary morbidities and mortality to chronic liver disease rather than complications from HIV. Treatment for hepatitis C virus (HCV) is strongly encouraged early in all coinfected patients. However, drug-drug interactions must be considered to ensure safe and tolerable use alone or in combination with antiretroviral therapies. The first-generation and newer HCV direct-acting antivirals are promising in coinfected patients, with minimal side effects and hepatotoxicity.

Keywords: ARV; Coinfection; DAAs; Drug-induced liver injury; HCV; HIV; Hepatotoxicity.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anti-Retroviral Agents / administration & dosage*
  • Anti-Retroviral Agents / therapeutic use
  • Antiviral Agents / adverse effects*
  • Antiviral Agents / therapeutic use
  • Chemical and Drug Induced Liver Injury / etiology*
  • HIV
  • HIV Infections / drug therapy
  • Hepacivirus / drug effects*
  • Hepatitis C, Chronic / drug therapy
  • Humans

Substances

  • Anti-Retroviral Agents
  • Antiviral Agents