title: Identification of a novel and severe pattern of efavirenz drug-induced liver injury in South Africa.
abstract: Efavirenz now forms part of many antiretroviral regimens in low and middle-income countries. Efavirenz-related drug-induced liver injury is not well characterized but is thought to occur less frequently than with nevirapine. We describe our observation of three defined clinicopathological patterns of injury, one of which, submassive necrosis, is associated with significant morbidity and mortality. A high baseline CD4, younger age and possibly female gender, predicts for the injury.
authors.affiliation: aDivision of Hepatology, Department of Medicine bDepartment of Anatomical Pathology and NHLS cInstitute of Infectious Disease and Molecular Medicine and Department of Medicine, University of Cape Town Faculty of Health Sciences and Groote Schuur Hospital, Observatory, Cape Town, South Africa.
authors.forename: Mark W
authors.initials: MW
authors.lastname: Sonderup
authors.forename: Debbie
authors.initials: D
authors.lastname: Maughan
authors.forename: Neliswa
authors.initials: N
authors.lastname: Gogela
authors.forename: Mashiko
authors.initials: M
authors.lastname: Setshedi
authors.forename: Helen
authors.initials: H
authors.lastname: Wainwright
authors.forename: Graeme
authors.initials: G
authors.lastname: Meintjes
authors.forename: Wendy
authors.initials: W
authors.lastname: Spearman
mesh_terms: D000328:Adult; D000480:Alkynes; D048588:Benzoxazines / Q000008:administration & dosage / Q000009:adverse effects*; D056486:Chemical and Drug Induced Liver Injury / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology*; D003521:Cyclopropanes; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D008297:Male; D011247:Pregnancy; D011446:Prospective Studies; D012189:Retrospective Studies; D018894:Reverse Transcriptase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D012307:Risk Factors; D013019:South Africa; D016019:Survival Analysis
chemical_list: D000480:Alkynes; D048588:Benzoxazines; D003521:Cyclopropanes; D018894:Reverse Transcriptase Inhibitors; C098320:efavirenz