Mary Fowler

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Nevirapine-Associated Hepatotoxicity and Rash among HIV-Infected Pregnant Women in Kenya.

Philip J Peters; Nicholas Polle; Clement Zeh; Rose Masaba; Craig B Borkowf; Boaz Oyaro; Paul Omolo; Paul Ogindo; Richard Ndivo; Frank Angira; et al. (Profiled Author: Mary Fowler)

1Centers for Disease Control and Prevention, Atlanta, GA, USA.
Journal of the International Association of Physicians in AIDS Care (Chicago, Ill. : 2002) 2012;11(2):142-9.

UNLABELLED: Background: Few studies have evaluated the risk of nevirapine (NVP)-associated hepatotoxicity among HIV-infected pregnant women with a CD4 count ≥250 cells/mm(3). METHODS: We enrolled HIV-infected pregnant Kenyan women who initiated triple antiretroviral therapy (ART) at 34 weeks gestation. We compared the rates of severe hepatotoxicity (grades 3-4 hepatotoxicity) and rash-associated hepatotoxicity (rash with ≥grade 2 hepatotoxicity) with NVP and nelfinavir (NFV), respectively. RESULTS: We initiated triple ART in 522 pregnant women; severe hepatotoxicity and rash-associated hepatotoxicity occurred in 14 (3%) and 9 (2%) women, respectively. Women who initiated NVP had higher rates of severe hepatotoxicity (5% vs 1%; P = .03) and rash-associated hepatotoxicity (4% vs 0%; P = .003) when compared with NFV. Among women who initiated NVP (n = 254), a baseline CD4 count ≥250 cells/mm(3) was not associated with severe hepatotoxicity (5% vs 3%; P = .52) or rash-associated hepatotoxicity (4% vs 3%; P = .69). CONCLUSION: Nevirapine use but not CD4 count ≥250 cells/mm(3) was associated with hepatotoxicity.

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