SAMJ: South African Medical Journal
On-line version ISSN 2078-5135
Print version ISSN 0256-9574
OBJECTIVE: To describe the incidence, clinical presentation and management of nevirapine-associated hepatitis among antiretroviral-naïve pregnant women treated with nevirapine-based antiretroviral therapy at a dedicated antenatal antiretroviral clinic. METHODS: Retrospective analysis of pregnant women initiated on nevirapine-based highly active antiretroviral therapy at a dedicated antenatal antiretroviral clinic between July 2004 and December 2006. RESULTS: Three hundred and ninety women were included in the analysis. Median age was 29 (interquartile range (IQR) 26 - 32) years and median pre-treatment CD4 cell counts was 157 (IQR 104 - 193) cells/µl. Baseline alanine transaminase (ALT) was elevated in 2.8% of women (11/390). After initiation of nevirapine-based ART 8% (31/390) experienced an ALT elevation. Three of these patients developed clinical hepatitis with jaundice (0.8%, 3/390). The mean and median time to clinical presentation was 5 weeks. Hepatitis resolved following discontinuation of ART. Non-nevirapine regimens were initiated following biochemical and symptomatic improvement; symptoms did not recur. CONCLUSIONS: Among pregnant women, nevirapine-containing ART has a favourable safety profile, with a low incidence of serious hepatic events.