Document Detail


Antiretroviral-induced hepatotoxicity presenting as nonreassuring fetal testing.
MedLine Citation:
PMID:  20664438     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Combination antiretroviral therapy is recommended for pregnant women with human immunodeficiency virus (HIV) to decrease perinatal transmission. Treatment can cause mitochondrial dysfunction, leading to liver damage and acidosis. Early diagnosis is essential to improve outcome. CASE: A multiparous woman with HIV-1 taking combination antiretroviral therapy presented with pneumonia at 28 weeks of gestation. Once treated, she improved clinically. However, nonreassuring fetal testing prompted further assessment, revealing maternal metabolic acidosis and transaminitis. Drug-induced hepatotoxicity was diagnosed, and combination antiretroviral therapy was discontinued. Fetal testing and maternal lab abnormalities subsequently improved. CONCLUSION: Usual manifestations of hepatotoxicity and acidosis secondary to combination antiretroviral therapy include nausea, vomiting, and jaundice. In this case, nonreassuring fetal testing led to the diagnosis of hepatic dysfunction. Abnormal fetal testing can result from drug-related toxicity and warrants prompt assessment.
Authors:
Nadine Kassis; Asha Heard; Nicole Sprawka; Susan Cu-Uvin; Brenna Anderson
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  116 Suppl 2     ISSN:  1873-233X     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-28     Completed Date:  2010-08-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  515-7     Citation Subset:  AIM; IM    
Affiliation:
Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Women & Infants' Hospital, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
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MeSH Terms
Descriptor/Qualifier:
Anti-HIV Agents / adverse effects*
Drug-Induced Liver Injury / etiology*,  therapy
Female
Fetal Monitoring*
HIV Infections / complications,  drug therapy*
HIV-1*
Humans
Infectious Disease Transmission, Vertical / prevention & control
Pregnancy
Pregnancy Complications, Infectious / drug therapy*
Grant Support
ID/Acronym/Agency:
K12HD050108/HD/NICHD NIH HHS; K24AI066884/AI/NIAID NIH HHS
Chemical
Reg. No./Substance:
0/Anti-HIV Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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