article · International Journal of Innovative Research in Multidisciplinary Education
Antiretroviral therapy has significantly improved life expectancy for people living with HIV, but drug-induced liver injury presents a major clinical challenge that complicates ongoing treatment. This review synthesises current evidence on the prevalence, risk factors, and biological mechanisms driving liver toxicity caused by antiretroviral regimens. It evaluates standard diagnostic approaches, including liver function tests, medical imaging, biopsies, and structured causality assessment tools such as the Roussel Uclaf Causality Assessment Method. The work highlights the relevance of genetic and immunological markers, noting pre-treatment testing for specific alleles like HLA-B*5701 to prevent severe adverse reactions. Managing this condition relies heavily on active pharmacovigilance, routine liver monitoring, and tailored regimen modifications. Identifying critical gaps in current knowledge, the review calls for targeted research to strengthen therapeutic safety and protect liver function in affected populations.
While modern HIV therapies allow patients to live longer, the medications themselves can damage the liver. Understanding how this toxicity happens and how to detect it early allows clinicians to adjust treatment safely. Improving surveillance and diagnostic protocols prevents severe organ failure, reduces complications from lifelong therapy, and ensures patients receive effective, personalised medical care.
This work is a literature review and does not present a newly developed product, placing it at an early foundational stage. However, the insights could inform healthcare providers, diagnostic developers, and pharmaceutical companies developing safer antiretroviral regimens or pharmacogenomic screening tools. Practical application depends on further research and clinical validation of proposed biomarkers and monitoring frameworks.
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This narrative review explores antiretroviral therapy (ART) -associated drug-induced liver injury (DILI), a significant clinical concern in managing patients with HIV/AIDS. As ART improves life expectancy for people living with HIV, the risk of drug-related hepatotoxicity has become more prominent, often complicating therapeutic strategies. The review examines the prevalence, risk factors, and underlying mechanisms of ART-DILI, providing a comprehensive analysis of clinical manifestations and laboratory indicators that aid in diagnosis and differentiation from other liver pathologies. Current diagnostic tools, including liver function tests, imaging, and, where applicable, liver biopsies, are discussed alongside the application of causality assessment tools like the Roussel Uclaf Causality Assessment Method (RUCAM). Additionally, we highlight genetic and immunological markers that may predispose patients to hepatotoxicity, addressing the importance of HLA-B*5701 testing for abacavir hypersensitivity as a case example. The review also explores the role of ART regimen modification and pharmacovigilance in managing and mitigating DILI risk, emphasizing the need for regular monitoring and individualized therapy. By providing a broad overview of ART-DILI and identifying knowledge gaps, this review underscores the need for further research to optimize ART management and improve liver safety outcomes in people living with HIV.
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DOI: 10.58806/ijirme.2025.v4i8n14
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