Liver toxicity of antiretroviral drugs

Drug-induced liver injury (DILI) associated with antiretroviral treatment has represented an important side effect since the beginning of the HAART era. The lack of standard definition and specific markers makes assessment of DILI very challenging. Several clinical syndromes of DILI have been described over the years; the pathogenic mechanisms are not fully understood. Better knowledge of DILI, identification of high-risk patients using pharmacogenetics, and the availability of antiretroviral agents with improved safety profile have all contributed to decrease the incidence of DILI and to ameliorate its effects. Nevertheless, with an aging human immunodeficiency virus- (HIV-) infected population and increased survival, DILI will probably continue to represent a relevant entity in e HIV therapeutic management.