Nevirapine-induced stevens johnson-syndrome and fulminant hepatic failure requiring liver transplantation

Am J Transplant. 2010 Jul;10(7):1713-6. doi: 10.1111/j.1600-6143.2010.03153.x.


We describe a case of nevirapine-induced Stevens-Johnson Syndrome (SJS) and fulminant hepatic failure (FHF) requiring liver transplantation. Five weeks prior to admission, a 57-year-old female with HIV infection had been switched to a nevirapine-based regimen of highly active antiretroviral therapy (HAART) with a CD4 cell count of 695/mm(3). Examination of the explanted native liver at initial transplantation revealed massive hepatic necrosis consistent with drug-induced liver injury. Primary graft nonfunction complicated the early postoperative course and liver retransplantation was required. On follow-up 2 years later, she remains in good health with an undetectable viral load on an efavirenz-based regimen of HAART. To our knowledge, this is the first report of successful liver transplantation following SJS and FHF.

Publication types

  • Case Reports

MeSH terms

  • Anti-HIV Agents / adverse effects*
  • Anti-HIV Agents / therapeutic use
  • Antiretroviral Therapy, Highly Active / adverse effects
  • Antiretroviral Therapy, Highly Active / methods
  • Female
  • HIV Infections / drug therapy
  • Hemofiltration
  • Humans
  • Liver Failure, Acute / chemically induced*
  • Liver Failure, Acute / surgery
  • Liver Transplantation*
  • Middle Aged
  • Nevirapine / adverse effects*
  • Nevirapine / therapeutic use
  • Stevens-Johnson Syndrome / chemically induced*
  • Stevens-Johnson Syndrome / surgery
  • Treatment Outcome


  • Anti-HIV Agents
  • Nevirapine