Hepatotoxicity of Antiretroviral Drugs Is Reduced after Successful Treatment of Chronic Hepatitis C in HIV‐Infected Patients

Abstract

Sustained HCV clearance after IFN-based therapy reduces the risk of liver toxicity during antiretroviral therapy, which should further encourage the treatment of chronic hepatitis C in HIV-coinfected patients. In this population, prescription of PIs or efavirenz decreases and use of dydeoxynucleoside analogues increases the risk of hepatotoxicity.

Hepatotoxicity in 2011: advancing resolutely

“…Individuals with chronic viral (B or C) liver disease have an increased risk for idiosyncratic liver toxicity, at least with some drugs, owing to pharmacokinetic changes, disregulated cytokine expression, and altered drug metabolism pathways (38)(39)(40)(41)(42)(43). Non-alcoholic steatohepatitis and obesity have shown no greater risk for liver toxicity but in cases induced by methotrexate and tamoxifen (43)(44)(45)(46).…”

British HIV Association guidelines for the management of coinfection with HIV‐1 and hepatitis B or C virus 2010

“…All antiretrovirals have the potential to cause acute and long-term hepatotoxicity and this risk is increased two-to threefold in the presence of chronic liver disease such as that caused by hepatitis B or C [37]. This increased risk of hepatotoxicity largely disappears if the hepatitis is successfully treated [37].…”

“…This increased risk of hepatotoxicity largely disappears if the hepatitis is successfully treated [37]. Patients should therefore be carefully monitored for hepatotoxicity when highly active antiretroviral therapy (HAART) is commenced or changed.…”

HAART and Hepatotoxicity

“…Therefore, many studies propose that HIV/HCV co-infection may augment the risk of developing hepatotoxicity after ART and HCV act as an independent risk factor for the progression of hepatic disease in co-infected individuals during HAART. Hence, it has been advised that patients should be monitor for pre-existing liver diseases and most notably hepatitis B and C before initiating ART (Labarga et al, 2007).…”