Department of Pharmacy, Gono Bishwabidyalay, Dhaka, Bangladesh
Research Article
Pediatric and Adolescent Considerations in Antiretroviral-Induced Hepatotoxicity: Mechanisms, Risks, Monitoring and Management
Author(s): Fahmida Akter, Hure Jannat Jyoti, Sophia Hossain, Sadia Afroz, Eshita Akter, Sadman Radit Aurnab, Aqib Hossain Khan and Imtiaj Hossain Chowdhury*
The scale-up of Antiretroviral Therapy (ART) has transformed pediatric and adolescent Human Immunodeficiency Virus (HIV) infection into a manageable chronic disease. Children living with HIV now initiate therapy in infancy and remain on lifelong treatment, resulting in cumulative exposure to antiretrovirals and their toxicities. Hepatotoxicity, ranging from asymptomatic transaminase elevations to severe Drug-Induced Liver Injury (DILI), represents one of the most clinically significant adverse effects of ART. Although hepatotoxicity has been extensively described in adults, pediatric populations face unique vulnerabilities due to developmental pharmacokinetics, nutritional deficiencies, coinfections, and evolving metabolic risk factors during adolescence. This review synthesizes current evidence on mechanisms of ART-related hepatotoxicity, age-specific susceptibilities, and drug class.. View more»