Oseltamivir and acute hepatitis, reality association or coincidence?
Antonio Mastroianni1, Valeria Vangeli1, Sonia Greco1
1UOC Malattie Infettive e Tropicali, 220599Azienda Ospedaliera di Cosenza, Cosenza, Italy.
Abstract:
Oseltamivir is an orally administered antiviral medication that selectively inhibits the influenza neuraminidase enzymes that are essential for viral replication and it is active against both influenza A and B viruses. Oseltamivir is indicated for therapy or post-exposure prevention of influenza A and B. Side effects are uncommon and include mild nausea, gastrointestinal upset, dizziness, and headache. Despite widespread use, oseltamivir has not been associated with clinically apparent liver injury; however, there is growing evidence of possible toxic liver involvement during oseltamivir therapy. To the best of our knowledge, this is the first reported case in Italy linking the development of acute hepatitis and oseltamivir therapy, in a patient suffering from influenza H1N1 infection. We also present a review of the literature on cases of oseltamivir hepatotoxicity, through the consultation of PubMed database, the bibliographical references of various articles and an extensive search using Google. In view of the analyzed results, we suggest that experts should carefully consider the need for inclusion of potential serious liver reactions be added to the oseltamivir product label.
Insights
Oseltamivir, used for influenza treatment, may rarely cause acute hepatitis. This case highlights a potential link between oseltamivir therapy and liver injury, suggesting updated drug labeling.
Area of Science:
- Virology
- Hepatology
- Pharmacology
Background:
- Oseltamivir is a widely used antiviral for influenza A and B.
- It functions by inhibiting neuraminidase enzymes crucial for viral replication.
- While generally safe, rare instances of liver involvement are emerging.
Purpose of the Study:
- To report the first case in Italy of acute hepatitis linked to oseltamivir therapy in an H1N1 patient.
- To review existing literature on oseltamivir-associated hepatotoxicity.
- To evaluate the potential risk of liver injury from oseltamivir.
Main Methods:
- Case report of a patient with H1N1 influenza who developed acute hepatitis.
- Comprehensive literature review using PubMed, article references, and Google searches.
- Analysis of reported cases of oseltamivir hepatotoxicity.
Main Results:
- The study presents a unique case of acute hepatitis in an H1N1 patient undergoing oseltamivir treatment.
- Literature review identified other potential cases of oseltamivir-induced liver injury.
- Evidence suggests a possible association between oseltamivir and toxic liver involvement.
Conclusions:
- Oseltamivir therapy may be associated with rare but serious liver reactions.
- The current product label may not adequately reflect the risk of oseltamivir hepatotoxicity.
- Healthcare professionals should consider this potential adverse effect when prescribing oseltamivir.
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