CHSJ

Curr Health Sci J, vol. 50, no. 2, 2024

Liver Damage During Treatment with Reverse-Transcriptase Inhibitors in HIV Patients

[Review]

G.N. LUNGU(1), G.I. DIACONESCU(2,9), F. DUMITRESCU(2,3), A.O. DOCEA(4), R. MITRUT(1), L. GIUBELAN(2,3), O. ZLATIAN(5,6), P. MITRUT(7,8)


(1)Doctoral School, University of Medicine and Pharmacy of Craiova, Romania;
(2)“Victor Babes” Infectious Diseases and Pneumophtisiology Clinical Hospital, Craiova, Romania;
(3)Department of Infectious Diseases, University of Medicine and Pharmacy of Craiova, Romania;
(4)Department of Toxicology, University of Medicine and Pharmacy of Craiova, Romania;
(5)Microbiology Department, University of Medicine and Pharmacy of Craiova, Romania;
(6)Medical Laboratory, County clinical emergency hospital of Craiova, Romania;
(7)Division of Internal Medicine, University of Medicine and Pharmacy of Craiova, Romania;
(8)Department of Internal Medicine II, County Clinical Emergency Hospital, Craiova, Romania;
(9)VITAPLUS Clinic, 200345 Craiova, Romania


Abstract:

The advent of highly active antiretroviral therapy (HAART) in 1996 has markedly enhanced the life expectancy of people living with HIV (PLWH), largely due to the effectiveness of reverse transcriptase inhibitors (RTIs). These drugs target the reverse transcriptase enzyme, crucial for the HIV virus to convert its RNA into DNA within host cells, effectively disrupting the viral replication process. This action reduces the patient’s viral load, helping preserve immune function and prevent progression to AIDS. Consequently, the predominant causes of mortality among individuals living with HIV have transitioned from opportunistic infections and AIDS-related cancers to liver disease and cardiovascular complications. Liver damage in PLWH could arise from multiple sources including co-infections, chronic substance use, and notably, antiretroviral therapy itself, which can be hepatotoxic. This review highlights the risks of hepatic damage associated with nucleoside and non-nucleoside RTIs and underscores the variability in hepatotoxicity risks among different drugs. It emphasizes the necessity for regular monitoring of liver health in PLWH and adjusting antiretroviral regimens to minimize liver fibrosis risk. This risk is particularly pronounced in patients who associate the infection with hepatitis B or C virus, where the potential for hepatotoxicity significantly increases


Keywords: HIV, hepatotoxicity, mitochondrial dysfunction, reverse transcriptase inhibitors.



Corresponding: Giorgiana Nicoleta Lungu, Doctoral School, University of Medicine and Pharmacy of Craiova, e-mail: lungugiorgiananicoleta@gmail.com


DOI 10.12865/CHSJ.50.02.03 - Download PDF
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