Dolutegravir induced sub-acute hepatic failure in HIV positive treatment naïve man in Botswana

Dolutegravir associated hepatic failure has rarely been reported. Hepatic failure can occur either acutely or after few weeks as it happened in our patient. We report a case of 61 years old HIV-positive treatment naïve patient who started experiencing features of hepatic injury one month after starting Dolutegravir-based regimen. Patient presented late with overt hepatic failure. We emphasize the importance of close monitoring both at initiation and long-term so as identify patients with early hepatic injury and limit fatal outcomes which are potentially avoidable.