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HIV-Related Liver Disease: ARV Drugs, Coinfection, and Other Risk Factors

Department of Infectious and Tropical Diseases, University of Brescia, AO Spedali Civili, Brescia, Italy, massimopuoti{at}libero.it

Paola Nasta, MD

Department of Infectious and Tropical Diseases, University of Brescia, AO Spedali Civili, Brescia, Italy

Francesca Gatti, MD

Department of Infectious and Tropical Diseases, University of Brescia, AO Spedali Civili, Brescia, Italy

Alessandro Matti, MD

Department of Infectious and Tropical Diseases, University of Brescia, AO Spedali Civili, Brescia, Italy

Katiela Prestini, MD

Department of Infectious and Tropical Diseases, University of Brescia, AO Spedali Civili, Brescia, Italy

Luciano Biasi, MD

Department of Infectious and Tropical Diseases, University of Brescia, AO Spedali Civili, Brescia, Italy

Giampiero Carosi, MD

Department of Infectious and Tropical Diseases, University of Brescia, AO Spedali Civili, Brescia, Italy

Highly-active antiretroviral therapy (HAART) has proven remarkably effective for prolonging the life of patients with human immunodeficiency virus (HIV). However, while most HAART agents are safe, many have the potential to cause liver toxicity. Physicians must therefore consider the possibility of drug-induced liver injury in the management of HIV-infected patients, especially those with certain risk factors such as coinfection with hepatitis B virus (HBV) or hepatitis C virus (HCV), female gender, alcohol abuse, older age, or obesity. Understanding how, when, and why drug-related liver damage occurs is key to managing these patients safely and effectively. Knowledge of HAART-related liver effects will help ensure that patients receive the most benefit with the least toxicity from any given drug regimen. As more information about the mechanisms of drug related liver injury is known, clinicians will be better able to tailor therapies to suit individual situations, resulting in greater patient safety and outcomes.

Key Words: highly active antiretroviral therapy • hepatitis B • hepatitis C • hepatic insufficiency • HIV-1

This version was published on January 1, 2009

Journal of the International Association of Physicians in AIDS Care (JIAPAC), Vol. 8, No. 1, 30-42 (2009)
DOI: 10.1177/1545109708330906


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