Severe hepatotoxicity associated with nevirapine use in HIV-infected subjects.


Journal Article

Human immunodeficiency virus (HIV)-infected South African patients (n=468) received blinded lamivudine or emtricitabine, stavudine, and either nevirapine or efavirenz (based on screening viral load). Baseline characteristics were analyzed in univariate and multivariate regression, to identify risk factors for hepatotoxicity (grade 3 or greater increase in serum aminotransferase levels). The occurrence of early hepatotoxicity was 17% in the nevirapine group and 0% in the efavirenz group and was balanced between the lamivudine and emtricitabine arms. Two subjects died of hepatic failure. Independent risk factors were body-mass index (BMI) <18.5, female sex, serum albumin level <35 g/L, mean corpuscular volume >85 fL, plasma HIV-1 RNA load <20,000 copies/mL, aspartate aminotransferase level <75 IU/L, and lactate dehydrogenase level <164 IU/L. The use of nevirapine in female patients with a low BMI should be discouraged.

Full Text

Duke Authors

Cited Authors

  • Sanne, I; Mommeja-Marin, H; Hinkle, J; Bartlett, JA; Lederman, MM; Maartens, G; Wakeford, C; Shaw, A; Quinn, J; Gish, RG; Rousseau, F

Published Date

  • March 15, 2005

Published In

Volume / Issue

  • 191 / 6

Start / End Page

  • 825 - 829

PubMed ID

  • 15717255

Pubmed Central ID

  • 15717255

International Standard Serial Number (ISSN)

  • 0022-1899

Digital Object Identifier (DOI)

  • 10.1086/428093


  • eng

Conference Location

  • United States