Anti-Retroviral Drug Hepatotoxicity and Risk Factors in HIV Patients with or Without Hepatitis B and C: A Review

Wambani Jr,Ogola Pe

doi:10.4172/2332-0877.1000258

Abstract

Physicians are treating patients infected with human immunodeficiency virus and/or hepatitis B or hepatitis C in their practice more often. Long-term complications of this diseases are multifactorial and can be related to the virus itself or to adverse effects of antiretroviral therapy. The liver is the main organ for regulating the internal environment of a body. There is no way to compensate for the loss of a liver function. It has major influences on the flow of nutrients as well as controlling carbohydrate, protein and fat metabolism. Drugs are significant in causing liver injury. More than nine hundred drugs, herbs and toxins have been documented as being hepatotoxic in line with different risk factors. The incidences of severe hepatic injury vary among different study cohorts as well as the differences in risk factors. Patients with a co-infection of HIV and Hepatitis B or C are at a risk of getting liver injury from antiretroviral drugs because the co-infections accelerate liver injury that may lead to cirrhosis or hepatocellular carcinoma. The risk of liver damage for those with a monoinfection of HIV alone is lower than in co-infections. This review explores risk factors for hepatotoxicity, its hepatotoxic antiretroviral drugs and the mechanisms of toxicity. It is meant to highlight the hepatotoxic potential of different antiretroviral drugs currently in use by HIV infected individuals.

Highlights

Survival rates in individuals with human immunodeficiency virus (HIV) infections have improved with access to early treatment; it has been recommended that individuals with HIV begin antiretroviral therapy (ART) if they have a CD4+ cell count of 500 per mm3 (0.50 or less) [1,2,3,4]
Henry J cited by Dietrich et al states that antiretroviral therapy (ART) has led to reductions in morbidity and mortality associated with HIV infections [5]
This review explores risk factors for hepatotoxicity, hepatotoxic antiretroviral drugs and the mechanisms of toxicity of these drugs

Summary

Introduction

Survival rates in individuals with human immunodeficiency virus (HIV) infections have improved with access to early treatment; it has been recommended that individuals with HIV begin antiretroviral therapy (ART) if they have a CD4+ cell count of 500 per mm3 (0.50 or less) [1,2,3,4]. Studies indicate that ART related hepatic enzyme elevations are more pronounced in HIV subjects with a co-infection of HBV or HCV [9,15,16,17]. A potential justification for higher risk of hepatotoxicity in individuals with elevated baseline aminotransferase levels and a co-infection with hepatitis C maybe that they interfere with drug metabolism [21].

Results

Conclusion