Hepatic impairment is less likely to affect UGT1A1 metabolism in comparison to other liver metabolic pathways. A recent study evaluated the effect of liver impairment on raltegravir pharmacokinetics in 20 HIV-negative patients (ten patients with moderate hepatic insufficiency and ten healthy, matched controls). The geometric mean ratios (GMR: mean value for the group with moderate hepatic insufficiency/mean value for the healthy controls) and 90% confidence intervals (CIs) for the area under the concentration-time curve from time zero to infinity (AUC0- ∞ ), the maximum concentration of drug in plasma (Cmax), and the concentration at 12 h (C12) were 0.86 (90% CI, 0.41, 1.77), 0.63 (90% CI, 0.23, 1.70), and 1.26 (90% CI, 0.65, 2.43), respectively. The study authors determined that liver impairment produced no clinically significant effects on raltegravir pharmacokinetics and therefore no dose adjustments are needed for mild to moderate hepatic insufficiency.