福沙那韋(226700-79-4,Fosamprenavir,GW433908,Lexiva,Telzir)毒理性質(zhì)：

Some degree of serum aminotransferase elevations occur in a high proportion of patients taking amprenavir or fosamprenavir containing antiretroviral regimens. In large, multicenter trials of fosamprenavir based antiretroviral therapy, moderate-to-severe elevations in serum aminotransferase levels (>5 times the upper limit of normal) were found in 3% to 10% of patients. Rates of enzyme elevations are higher in patients with HIV-HCV coinfection then in those with monoinfection. These elevations are usually asymptomatic and self-limited and can resolve even with continuation of the medication. Furthermore, similar rates of enzyme elevations were found in comparator arms (using other HIV protease inhibitors). Clinically apparent acute liver injury due to amprenavir or fosamprenavir is rare and the specific clinical features have not been characterized in any detail. The few cases of symptomatic liver injury that have been reported have arisen after 1 to 8 weeks of starting the agent, and the pattern of serum enzyme elevations has not been well defined, but probably largely hepatocellular (Cases 1 and 2). Signs of hypersensitivity (fever, rash, eosinophilia) can occur, but autoantibody formation is rare. The acute liver injury due to HIV protease therapy is usually self-limited, but it can be severe, and isolated cases of acute liver failure have been reported with some agents. In HBV or HCV coinfected patients, acute liver injury may be caused by an exacerbation of the underlying chronic liver disease, perhaps as a result of sudden immune reconstitution. Neither amprenavir nor fosamprenavir have been clearly linked to lactic acidosis and acute fatty liver that is reported in association with several nucleoside analogue reverse transcriptase inhibitors. Likelihood score: D (possible rare cause of clinically apparent liver injury)