To Treat or Not to Treat: A Twist in Paxlovid-Induced Liver Injury Amidst Severe Fatty Liver Disease

<p>Paxlovid, a combination of nirmatrelvir and ritonavir, has emerged as a critical therapeutic option for the treatment of COVID-19, particularly in high-risk patients. Its efficacy in reducing viral load and preventing severe outcomes has been welldocumented, leading to widespread use during the pandemic. However, the drug’s interaction profile and potential adverse effects, especially in patients with pre-existing liver or kidney disease, pose significant challenges. Ritonavir, a component of Paxlovid, is a potent inhibitor of the cytochrome P450 3A4 (CYP3A4) enzyme, which can lead to increased plasma levels of co-administered drugs and potential hepatotoxicity.</p>