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Semin Liver Dis 2003; 23(2): 167-172
DOI: 10.1055/s-2003-39947
Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Hepatotoxicity of Nucleoside Reverse Transcriptase Inhibitors

Valentina Montessori1,2 , Marianne Harris2 , Julio S.G. Montaner2,3
  • 1Clinical Assistant Professor, University of British Columbia, Vancouver, Canada
  • 2the BC Centre for Excellence in HIV and AIDS, Vancouver, Canada
  • 3University of British Columbia, Vancouver, Canada
Further Information

Publication History

Publication Date:
11 June 2003 (online)

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ABSTRACT

Hepatotoxicity is an adverse effect of all available classes of antiretrovirals, including nucleoside reverse transcriptase inhibitors (NRTI). A syndrome of hepatic steatosis and lactic acidosis has been recognized as a rare, potentially fatal complication since the advent of NRTI monotherapy in the early 1990s. Today, NRTI remain the backbone of antiretroviral combination regimens, and, with the success of current treatment strategies, exposure to two or more of these agents may occur over a number of years. Hepatic steatosis and lactic acidosis are accordingly being observed more frequently, along with a more recently recognized syndrome of chronic hyperlactatemia. These as well as other adverse effects of NRTI are mediated by inhibition of human DNA polymerase γ, resulting in mitochondrial dysfunction in the liver and other tissues. Early recognition and intervention are essential to avert serious outcomes.

KEYWORDS

NRTI - hepatotoxicity

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