Nevirapine-induced stevens johnson-syndrome and fulminant hepatic failure requiring liver transplantation.
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.
Jao
J
J
Department of Medicine, Mount Sinai Hospital and School of Medicine, New York, NY, USA. jennifer.jao@mssm.edu
Sturdevant
M
M
del Rio Martin
J
J
Schiano
T
T
Fiel
M I
MI
Huprikar
S
S
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
D019380:Anti-HIV Agents; D019829:Nevirapine