HIV antiretroviral medications and hepatotoxicity.

PURPOSE OF REVIEW

This review considers the differential diagnosis, pathophysiology and risk of hepatotoxicity of specific antiretroviral medications.

RECENT FINDINGS

Currently prescribed antiretroviral medications are associated with an incidence of grade 3/4 liver enzyme elevation of less than 5%. Clinically apparent hepatotoxicity rates are much lower. The risk of adverse events with combination HIV and hepatitis C virus treatments is low, assuming that several nucleosides including didanosine and stavudine are avoided.

SUMMARY

Irrespective of the HIV antiretroviral regimen prescribed, careful observation of liver function and enzymes is advised, especially in those with comorbid liver disease. The majority of patients do not experience treatment-limiting liver toxicities, achieve virological suppression, and realize immunological restoration.