Curbside Consultation of the Liver: 49 Clinical Questions

Mitchell L. Shiffman, MD

Question 18: Should I Stop Hiv Medications In A Patient Who Has Developed An Elevation In Serum Transaminases? (continued)

Richard K. Sterling, MD, MSc, FACP, FACG

With the advent of highly active antiretroviral therapy (HAART), which combines various nucleoside/nucleotide analogue reverse transcriptase inhibitors (NRTIs), nonnucleoside reverse transcriptase inhibitors (NNRTIs), and protease inhibitors (PIs), the morbidity and mortality related to human immunodeficiency virus (HIV) have significantly decreased. As a result, patients are now living longer with HIV infection and other comorbidities and hepatic events have emerged as a key issue in the management of HIV-infected patients.1,2 Before you consider what to do in the HIV patient with elevated…