Acute liver failure associated with antiretroviral treatment for HIV: a report of six cases.

Sarah J. Clark, Sarah Creighton, Bernard Portmann*, Christopher Taylor, Julia A. Wendon, Matthew E. Cramp

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND/AIMS: Severe hepatotoxicity is a rare but potentially fatal side effect of all antiretrovirals. We report a series of six human immunodeficiency virus (HIV)-infected patients admitted with acute liver failure (ALF) over a 25-month period, of whom five died. All had been treated with a range of antiretroviral therapy and only two had had acquired immune deficiency syndrome (AIDS) defining illnesses. RESULTS: Median duration of antiretroviral therapy was 12.5 months (range 1-23). Median time from the introduction of new antiretroviral therapy to the onset of ALF was 8 weeks (range 2-12). The development of ALF was unrelated to duration of HIV treatment or type of antiretroviral therapy, and was not predicted by close out-patient supervision and monitoring of liver function. Biochemical investigations were variable but revealed a predominantly hepatocellular pattern. Liver biopsy revealed typical features of mitochondrial toxicity in only one case, with confluent hepatocellular necrosis, inflammation and cholestasis seen in the others. CONCLUSIONS: There is a need to increase awareness of the potential hepatotoxicity of antiretroviral therapy and to develop means of predicting its development. With increasing usage of antiretroviral therapy, severe hepatotoxicity and ALF may arise more frequently, and the outcome is poor despite intensive supportive therapy.
Original languageEnglish
Pages (from-to)295-301
Number of pages0
JournalJ Hepatol
Volume36
Issue number2
DOIs
Publication statusPublished - Feb 2002

Keywords

  • Adult
  • Antiretroviral Therapy
  • Highly Active
  • Fatal Outcome
  • Female
  • HIV Infections
  • Humans
  • Liver Failure
  • Acute
  • Male
  • Middle Aged

Fingerprint

Dive into the research topics of 'Acute liver failure associated with antiretroviral treatment for HIV: a report of six cases.'. Together they form a unique fingerprint.

Cite this