Does hepatotoxicity occur in everyone taking anti-HIV drugs?
No, it does not. There have been a number of studies looking at the percentage
of patients who develop hepatotoxicity, according to the different anti-HIV
medications they are taking. One particular study, conducted by researchers
at the National Institutes of Health, looked at rates of hepatotoxicity
among 10,611 HIV-positive people participating in 21 government-funded
clinical trials conducted between 1991 and 2000. Overall, 6.2% of the
clinical trial participants experienced severe hepatotoxicity. Among the
participants who took a non-nucleoside reverse
transcriptase inhibitor (either Viramune, Sustiva, or Rescriptor)
in combination with two nucleoside analogues,
severe hepatotoxicity occurred in 8.2%. Among the participants who took
a protease inhibitor in combination with two
nucleoside analogues, severe hepatotoxicity occurred in 5%.
Unfortunately, clinical trials do not always reflect what is going to
happen in the real world. Many clinical trials only follow participants
for a year – and we know that HIV-positive people will need to take
these medications for many years, which can increase the risk of hepatotoxicity.
What's more, most clinical trials enroll patients who don't have other
conditions that can further increase the risk of hepatotoxicity. For example,
it is believed that women and people over the age of 50 are at a higher
risk of developing hepatotoxicity. Obesity and heavy alcohol use can also
increase the chances of hepatotoxicity occurring. There is also a very
real concern that HIV-positive people who are coinfected with hepatitis
B or hepatitis C are more likely to experience hepatotoxicity than those
who are only infected with HIV.
Search for news stories about this topic