Lack of hepatotoxicity associated with nonnucleoside reverse transcriptase inhibitors

Ron Palmon, Bon Chang A. Koo, David A. Shoultz, Douglas T. Dieterich

Research output: Contribution to journalArticlepeer-review

76 Scopus citations


Nonnucleoside reverse transcriptase inhibitors (NNRTIs), particularly nevirapine, have been associated with hepatotoxicity. We performed a retrospective study to determine the incidence of NNRTI hepatotoxicity in a group of HIV-infected patients from a New York City practice. These patients are predominantly homosexual white males. We also analyzed the effect of coinfection with hepatitis B (HBV) or hepatitis C (HCV) virus. In total, 272 patients received NNRTIS: 40 (15%) received delavirdine, 91 (33%) received efavirenz, and 141 (52%) received nevirapine. Of the patients with known hepatitis status, 18 of 190 (9%) were coinfected with HBV, and 24 of 205 were coinfected (12%) with HCV. The overall rate of grade 3 to 4 elevations in aspartate aminotransferase (AST) or alanine aminotransferase (ALT) was 3 of 272 (1.1%) and did not differ significantly among the three NNRTIs. HBV or HCV was not associated with a significant increase in AST or ALT elevations. We conclude that NNRTIs are relatively free from hepatotoxicity in this population, despite the presence of coinfection with HBV or HCV.

Original languageEnglish
Pages (from-to)340-345
Number of pages6
JournalJournal of Acquired Immune Deficiency Syndromes
Issue number4
StatePublished - 1 Apr 2002
Externally publishedYes


  • HIV-1
  • Hepatotoxicity
  • Nonnucleoside reverse transcriptase inhibitors


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