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Research letter
A case of rilpivirine drug-induced liver injury
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  1. Ming Jie Lee1,
  2. Philip Berry2,
  3. Francesca D'Errico2,
  4. Rosa Miquel3,
  5. Ranjababu Kulasegaram1
  1. 1 Harrison Wing Department, Guy's and St Thomas Hospital NHS Foundation Trust, London, UK
  2. 2 Department of Gastroenterology and Hepatology, Guy's and St Thomas Hospital NHS Foundation Trust, London, UK
  3. 3 Liver Histopathology Laboratory, Institute of Liver Studies, King's College Hospital NHS Foundation Trust, London, UK
  1. Correspondence to Dr Ming Jie Lee, Harrison Wing Department, Guy's and St Thomas Hospital NHS Foundation Trust, London SE1 9RS, UK; minglee{at}doctors.org.uk

https://doi.org/10.1136/sextrans-2019-054336

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    Liver toxicity is a frequent adverse event following antiretroviral therapy for HIV, ranging from asymptomatic increases in liver enzymes to fulminant liver failure.1 2 Rilpivirine is a second-generation non-nucleoside reverse transcriptase inhibitor with low rates of liver enzyme elevations.3 We report a case of acute hepatitis secondary to rilpivirine with histological documentation.

    A 27-year-old Mediterranean man was diagnosed with HIV, with a baseline CD4 count of 0.359 ×109/L and an HIV-1 viral load of 21 525 copies/mL. His last negative HIV test was 2 years prior. His medical history included depression, G6PD deficiency and a beta thalassaemia carrier status. He reported minimal alcohol intake. His baseline liver markers were normal.

    Abacavir/lamivudine 600/300 mg once daily and raltegravir 400 mg two times per day were started on week 4 following diagnosis. Raltegravir was switched to rilpivirine 25 mg once …

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