Hepatotoxicity during nevirapine-based fixed-dose combination antiretroviral therapy in Kampala, Uganda

Judith A. Hahn, Marissa Maier, Jayne Byakika-Tusiime, Jessica H. Oyugi, David R. Bangsberg

Research output: Contribution to journalArticle

16 Scopus citations

Abstract

Background: Generic, low-cost, nevirapine (NVP)-based antiretroviral therapy (ART) has improved survival in HIV-infected individuals living in resource-limited settings. However, there is concern about the potential hepatotoxicity of these regimens. Methods: The authors conducted a prospective study of persons initiating self-pay Triomune or Maxivir therapy in Kampala, Uganda. Results: The 97 study participants were predominantly women (64%), median age was 35 (interquartile range [IQR] 30-40), median CD4 at baseline was 56 cells/mm 3 (IQR 8-138), and 19% had lifetime alcohol problems (CAGE < 2). Severe liver enzyme elevations (LEEs) of grade 3-4 were rare (2.2%); however, 1 patient died in the setting of grade 4 LEEs. Grade 1-4 LEEs occurred among 22.2% of participants, and 9.8% had new grade 1-4 LEEs after the initiation of treatment. Discussion: The authors found that LEEs were common but that severe hepatotoxicity in persons initiating NVP-based ART was infrequent yet potentially life-threatening. Monitoring for NVP-related severe hepatic toxicity should be part of expanding antiretroviral treatment programs in resource-limited settings.

Original languageEnglish (US)
Pages (from-to)83-86
Number of pages4
JournalJournal of the International Association of Physicians in AIDS Care
Volume6
Issue number2
DOIs
StatePublished - Jun 1 2007
Externally publishedYes

Keywords

  • HIV
  • Uganda
  • antiretroviral therapy
  • hepatotoxicity

ASJC Scopus subject areas

  • Immunology
  • Dermatology
  • Infectious Diseases

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