Hepatotoxicity after Prophylaxis with a Nevirapine-Containing Antiretroviral Regimen
Authors: Stuart Johnson, Juliana Chan, Charles L. Bennett
Journal: Annals of Internal Medicine (2002)

Letters16 July 2002Hepatotoxicity after Prophylaxis with a Nevirapine-Containing Antiretroviral RegimenStuart Johnson, MD, Juliana Chan, PharmD, and Charles L. Bennett, MD, PhDStuart Johnson, MDChicago VA Healthcare System/Lakeside Division; Chicago, IL (Johnson)University of Illinois at Chicago; Chicago, IL (Chan)Chicago VA Healthcare System/Lakeside Division; Chicago, IL (Bennett)Search for more papers by this author, Juliana Chan, PharmDChicago VA Healthcare System/Lakeside Division; Chicago, IL (Johnson)University of Illinois at Chicago; Chicago, IL (Chan)Chicago VA Healthcare System/Lakeside Division; Chicago, IL (Bennett)Search for more papers by this author, and Charles L. Bennett, MD, PhDChicago VA Healthcare System/Lakeside Division; Chicago, IL (Johnson)University of Illinois at Chicago; Chicago, IL (Chan)Chicago VA Healthcare System/Lakeside Division; Chicago, IL (Bennett)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-137-2-200207160-00025 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Postexposure prophylaxis is recommended after high-risk occupational HIV exposure in health care workers (1). Some regimens include non-nucleoside reverse transcriptase inhibitors because these agents have favorable pharmacokinetics and dosing schedules and have successfully prevented mother-to-child HIV transmission (2). The use of nevirapine, a non-nucleoside reverse transcriptase inhibitor, is complicated by 1% rates of hepatotoxicity and the Stephens–Johnson syndrome in HIV-infected persons (3). Nevirapine-associated hepatotoxicity has been noted in 8 of 41 healthy volunteers in phase I trials and in 5 of 41 sexual partners of HIV-infected persons who received postexposure prophylaxis that contained nevirapine (4). Fortunately, in ...References1. Public Health Service guidelines for the management of health-care worker exposures to HIV and recommendations for postexposure prophylaxis. MMWR Morb Mortal Wkly Rep. 1998; 15:47:1-33. Google Scholar2. Kahn JO, Martin JN, Roland ME, Bamberger JD, Chesney M, Chambers D, et al . Feasibility of postexposure prophylaxis (PEP) against human immunodeficiency virus infection after sexual or injection drug use exposure: the San Francisco PEP study. J Infect Dis. 2001;183:707-14. [PMID: 11181146] CrossrefMedlineGoogle Scholar3. Pollard RB, Robinson P, Dransfield K. Safety profile of nevirapine, a nonnucleoside reverse transcriptase inhibitor for the treatment of human immunodeficiency virus infection. Clin Ther. 1998;20:1071-92. [PMID: 9916603] CrossrefMedlineGoogle Scholar4. Benn PD, Mercey DE, Brink N, Scott G, Williams IG. Prophylaxis with a nevirapine-containing triple regimen after exposure to HIV-1. Lancet. 2001;357:687-8. [PMID: 11247556] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Chicago VA Healthcare System/Lakeside Division; Chicago, IL (Johnson)University of Illinois at Chicago; Chicago, IL (Chan)Chicago VA Healthcare System/Lakeside Division; Chicago, IL (Bennett)Acknowledgments: The authors thank Karen G. Lloyd, BA; Beverly E. Sha, MD; Rosaria Battaglini, RN; Anjuli Dey, BSN; Harold A. Kessler, MD; Dennis Raisch, PhD; Catherine Creticos, MD; and Thomas J. Layden, MD, for their contributions to this investigation. 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