title: Nevirapine-induced stevens johnson-syndrome and fulminant hepatic failure requiring liver transplantation.
abstract: We describe a case of nevirapine-induced Stevens-Johnson Syndrome (SJS) and fulminant hepatic failure (FHF) requiring liver transplantation. Five weeks prior to admission, a 57-year-old female with HIV infection had been switched to a nevirapine-based regimen of highly active antiretroviral therapy (HAART) with a CD4 cell count of 695/mm(3). Examination of the explanted native liver at initial transplantation revealed massive hepatic necrosis consistent with drug-induced liver injury. Primary graft nonfunction complicated the early postoperative course and liver retransplantation was required. On follow-up 2 years later, she remains in good health with an undetectable viral load on an efavirenz-based regimen of HAART. To our knowledge, this is the first report of successful liver transplantation following SJS and FHF.
authors.affiliation: Department of Medicine, Mount Sinai Hospital and School of Medicine, New York, NY, USA. jennifer.jao@mssm.edu
authors.forename: J
authors.initials: J
authors.lastname: Jao
authors.forename: M
authors.initials: M
authors.lastname: Sturdevant
authors.forename: J
authors.initials: J
authors.lastname: del Rio Martin
authors.forename: T
authors.initials: T
authors.lastname: Schiano
authors.forename: M I
authors.initials: MI
authors.lastname: Fiel
authors.forename: S
authors.initials: S
authors.lastname: Huprikar
mesh_terms: D019380:Anti-HIV Agents / Q000009:adverse effects* / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects / Q000379:methods; D005260:Female; D015658:HIV Infections / Q000188:drug therapy; D006440:Hemofiltration; D006801:Humans; D017114:Liver Failure, Acute / Q000139:chemically induced* / Q000601:surgery; D016031:Liver Transplantation; D008875:Middle Aged; D019829:Nevirapine / Q000009:adverse effects* / Q000627:therapeutic use; D013262:Stevens-Johnson Syndrome / Q000139:chemically induced* / Q000601:surgery; D016896:Treatment Outcome
chemical_list: D019380:Anti-HIV Agents; D019829:Nevirapine