Hepatoxicity of new antiretrovirals: a systematic review

Clin Res Hepatol Gastroenterol. 2013 Apr;37(2):126-33. doi: 10.1016/j.clinre.2013.02.008. Epub 2013 Mar 21.


There has been a major paradigm shift in the management of HIV infected patients, with earlier initiation of antiretroviral treatment and lifelong exposure to drugs for which long-term safety issues must be faced by clinicians. Within the past 5 years, new drugs from both previously established and novel therapeutic classes have been released that tend to be safer and more efficient than their former combinations. Although hepatotoxicity was one of the most common side effects from initial antiretrovirals, phase II/III safety data regarding liver tolerance from more recent drugs are reassuring. However, data on the long-term exposure to these therapeutic options are needed, and a handful of case reports are emerging, reporting rare but potentially life-threatening adverse hepatic events in patients with hepatitis co-infection or taking other hepatotoxic drugs.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Anti-Retroviral Agents / adverse effects*
  • Chemical and Drug Induced Liver Injury / etiology*
  • Clinical Trials as Topic
  • Cyclohexanes / adverse effects
  • Darunavir
  • Heterocyclic Compounds, 3-Ring / adverse effects
  • Humans
  • Maraviroc
  • Nitriles / adverse effects
  • Oxazines
  • Piperazines
  • Pyridazines / adverse effects
  • Pyridones
  • Pyrimidines / adverse effects
  • Pyrrolidinones / adverse effects
  • Quinolones / adverse effects
  • Raltegravir Potassium
  • Rilpivirine
  • Sulfonamides / adverse effects
  • Triazoles / adverse effects


  • Anti-Retroviral Agents
  • Cyclohexanes
  • Heterocyclic Compounds, 3-Ring
  • Nitriles
  • Oxazines
  • Piperazines
  • Pyridazines
  • Pyridones
  • Pyrimidines
  • Pyrrolidinones
  • Quinolones
  • Sulfonamides
  • Triazoles
  • etravirine
  • Raltegravir Potassium
  • elvitegravir
  • dolutegravir
  • Rilpivirine
  • Maraviroc
  • Darunavir