cells Review Hepatotoxicity of Contemporary Antiretroviral Drugs: A Review and Evaluation of Published Clinical Data Ashley O. Otto 1 , Christina G. Rivera 1, John D. Zeuli 1 and Zelalem Temesgen 2,* 1 Department of Pharmacy, Mayo Clinic, Rochester, MN 55905, USA;
[email protected] (A.O.O.);
[email protected] (C.G.R.);
[email protected] (J.D.Z.) 2 Division of Infectious Diseases, Mayo Clinic, Rochester, MN 55905, USA * Correspondence:
[email protected] Abstract: Contemporary antiretroviral agents afford enhanced potency and safety for patients living with HIV. Newer antiretroviral drugs are often better tolerated than those initially approved in the early stages of the HIV epidemic. While the safety profile has improved, adverse drug reactions still occur. We have segregated the antiretroviral agents used in contemporary practice into class groupings based on their mechanism of antiviral activity (non-nucleoside reverse transcriptase inhibitors, nucleoside reverse transcriptase inhibitors, integrase inhibitors, protease inhibitors, and entry inhibitors) while providing a review and discussion of the hepatoxicity seen in the most relevant clinical literature published to date. Clinical literature for individual agents is discussed and agent comparisons afforded within each group in tabular format. Our review will provide a summative overview of the incidence and medications associated with hepatic adverse reactions linked to the use of contemporary antiretroviral drugs. Keywords: human immunodeficiency virus; hepatotoxicity; antiretroviral therapy Citation: Otto, A.O.; Rivera, C.G.; Zeuli, J.D.; Temesgen, Z. Hepatotoxicity of Contemporary Antiretroviral Drugs: A Review and Evaluation of Published Clinical Data. 1. Introduction Cells 2021, 10, 1263. https://doi.org/ Since the introduction into practice of the first antiretroviral drug zidovudine in 1987, 10.3390/cells10051263 the development of new antiretroviral drugs has evolved at a rapid pace.