Hepatic Disease in HIV-Infected Patients

  • Author: Mark S. Sulkowski, MD (More Info)
  • Editors in Chief: Daniel R. Kuritzkes, MD; Joseph J. Eron, Jr., MD
  • Last Reviewed: 9/4/18 (What's New)

Summary

  • Treatment of HIV disease may ameliorate the development of chronic liver disease due to viral hepatitis[Shafran 2007]
  • Incidence
    • In randomized, controlled trials, the proportion of patients receiving combination ART who have grades 3 or 4 elevations in serum ALT or AST levels range from approximately 2% to 18%[Nuñez 2006]
    • Ritonavir-boosted PIs have not been associated with higher rates of hepatotoxicity
    Pathogenesis
      Mitochondrial Toxicity
        Immune reconstitution
          Direct Toxicity and/or Drug Metabolism
            Idiosyncratic Hypersensitivity Reactions
            Symptoms and Diagnosis
              Treatment of Drug-Induced Liver Disease

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