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Medical Science Monitor Basic Research

AmJCaseRep
MedSciTechnol

eISSN: 2329-0358

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Urgent liver transplantation for nevirapine-induced acute liver failure: Report of a case and review of the literature

Juan Carlos Lopez-Delgado, Rafael Mañez Mendiluce, Teresa Serrano Pinol, Xose Pérez Fernández, Laura Sanchez, Rosa Granada Vicente

Ann Transplant 2012; 17(1): 122-127

DOI: 10.12659/AOT.882645


Background:    Acute liver failure (ALF) due to antiretroviral treatment is a rare but a fatal complication in HIV-infected patients. Non-nucleoside retroviral transcriptase inhibitors are known to cause hepatotoxicity and exceptionally acute hepatic failure.
    Case Report:    We report a case of nevirapine-induced acute liver failure successfully managed with orthotopic liver transplantation (OLT). Antiretroviral therapy including raltegravir, zidovudine and abacavir was reintroduced 6 days after transplantation. No interaction with immunosuppressive agents was observed and the patient had a complete recovery.
    Conclusions:    Urgent OLT should be considered in HIV patients with nevirapine-induced ALF because of the poor outcome despite intensive supportive conservative treatment. Concomitant use of highly active antiretroviral therapy (HAART) and immunosuppression could be feasible if treatment is performed cautiously.

This paper has been published under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.
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