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Drug-Induced Liver Injury Associated with Antiretroviral Therapy that Includes HIV-1 Protease Inhibitors
Abstract
Since their introduction, hepatotoxicity has been associated with the use of human immunodeficiency virus (HIV)-1 protease inhibitors (PIs). However, the complexity of the HIV-infected patient and the combinations of medications used to treat HIV complicate the understanding of the independent effects of PIs in the development of drug-induced liver injury (DILI). I discuss the current understanding of PI-associated hepatotoxicity. Of the PI regimens studied, the greatest risk of DILI has been observed among patients receiving full-dose ritonavir. Similarly, hepatitis B and/or C virus coinfection has been associated with a greater risk of DILI, compared with those with no hepatitis. Although the specific mechanism by which viral hepatitis increases this risk is not known, patients with cirrhosis may have decreased cytochrome P450 activity, leading to increased PI exposure. Clearly, further research is needed to define the interaction of PIs and chronic viral hepatitis in the development of DILI.
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Cited by
Drug-induced liver injury: Interactions between drug properties and host factors
Chen, M., Suzuki, A., Borlak, J., Andrade, R. J., & Lucena, M. I. (2015) · Journal of Hepatology · doi:10.1016/j.jhep.2015.04.016 · Cited by 405
Zhang, D., Chando, T. J., Everett, D. W., Patten, C. J., Dehal, S. S., & Humphreys, W. G. (2005) · Drug Metabolism and Disposition · doi:10.1124/dmd.105.005447 · Cited by 286
Idiosyncratic drug-induced liver injury: an overview
Hussaini, S. H., & Farrington, E. A. (2007) · Expert Opinion on Drug Safety · doi:10.1517/14740338.6.6.673 · Cited by 183
Chirapongsathorn, S., Sukeepaisarnjaroen, W., Treeprasertsuk, S., Chaiteerakij, R., Surawongsin, P., Hongthanakorn, C., Siramolpiwat, S., Chamroonkul, N., Bunchorntavakul, C., Chotiyaputta, W., et al. (2022) · Journal of Clinical and Translational Hepatology · doi:10.14218/jcth.2021.00479 · Cited by 3
Metadata
- Authors
- Sulkowski, M. S.
- Venue
- Clinical Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2004-03-01
- Volume
- 38
- Issue
- Supplement_2
- Pages
- S90-S97
- ISSN
- 1058-4838 (ISSN-L)
- 1537-6591
- OpenAlex
- W1970513035
- Cited by
- 192
- References
- 0
- FWCI
- 10.35
- Type
- journal article
- Language
- en
- Open access
- closed
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