Efavirenz-Induced Hepatic Changes in the Fetus of Swiss Albino Mice

Efavirenz (EFV) is a non-nucleoside reverse transcriptase inhibitor that binds to reverse transcriptase enzyme resulting in its allosteric inhibition. It is a constituent of highly active antiretroviral therapy (HAART) used for preventing maternal-to-child transmission of the HIV virus. Efavirenz has been classified as a class D drug which means that there have been reports of reproductive toxicity induced by it and should be used only when potential benefits outweigh the risk. Pregnant Swiss albino mice were divided into the following groups: control group (C): mice treated with distilled water (6 mice) and treated group (T): mice treated with EFV (50 mg/kg) (6 mice). All the mice were given the drug and distilled water from gestation days 6-15 by oral route. On the 18th day of gestation, each group's mice blood was collected from retro-orbital sinus for biochemical assay, and then, they were killed by cervical dislocation. Laparotomy was done to resect out the fetuses which were weighed, and then fixed in 10% formalin. Their liver was processed for histological study under H&E and PAS stain. The microscopic study of the liver showed the reduced density of hepatoblasts and progenitor cells, deficient sinusoid formation and destruction of the central vein in the treated group as compared to the control. A significant reduction in the weight of the fetal liver was observed. The values of SGOT, SGPT and serum bilirubin were found to increase in the treated group, whereas the values of serum albumin and total protein were found to decrease. Efavirenz is a hepatotoxic drug that should be judiciously used in pregnancy.