抗艾滋病病毒药物的肝损伤

The hepatotoxicity of antiretrovirals in HIV

高效抗逆转录病毒治疗(HAART)已经明显地降低了艾滋病相关的发病率和死亡率。但是,接受HAART治疗的患者通常在遭受药物副作用的困扰。因此,HIV感染治疗已经成为持续HIV病毒抑制与药物毒性危险性之间复杂的平衡行为。HAART的毒性作用之一是肝毒性,其可造成HIV患者的治疗中断、亚临床肝炎,甚至出现致死性肝衰竭。目前,HAART导致肝毒性的机理尚不清楚。本文就HAART导致肝毒性的发病机制、发生率、临床影响、危险因素以及临床处理作一综述。

Highly active antiretroviral therapy （HAART） has dramatically reduced the morbidity and mortality of HIV infection. But patients with HIV infection on HAART commonly suffer from side effects. As a result, treatment of HIV infection has become a complicated balancing act between the benefits of durable HIV suppression and the risks of drug toxicity. One of the toxicities linked to the use of antiretrovirals is hepatotoxicity, which lead to treatment discontinuation, subclinical hepatitis even fatal hepatic failure in HIV-infected patients. The mechanisms involved in HAART-derived hepatotoxicity are not well understood. In this paper, the mechanisms, incidence, clinical impact, risk factors and management of antiretroviral hepatotoxicity are reviewed.