Matsuda J et al
Severe hepatitis in patients with AIDS and hemophilia B
treated with indinavir
Lancet
(Aug) 350:364 1997

In the March 29 Lancet,
Brau and colleagues decribed 3 patients with severe
hepatitis after
indinavir therapy. In the August 2 issue of the Lancet, Matsuda and
colleagues now
describe their experience in an additional male patients with mild hemophilia
B who
developed worsening liver enzymes, eosinophilia and elevated serum levels of
IgE,
consistent with severe drug-allergy hepatitis. Dr. Matsuda has apparently
had a similar
experience with 10 of 12 subsequent patients.
Thus, in addition to renal stones, crystalluria, and impaired renal function,
as reviewed
in a recent
Annals paper by Kopp et al., patients receiving indinavir
should be closely
monitored for changes in liver function.
(John T. Daugirdas, M.D., University of Illinois at Chicago)