Hepatitis and hepatic failure are uncommon adverse reactions to RAL, and grade 2 or 3serum ALT elevations have been reported.30 A case of high serum transaminase levels has been reported after adding RALto an ART regimen in a pregnant woman.31 Although we did not observe elevations in serum ALT levels, liver functionassessments in pregnant women receiving RAL remain warranted. Here, GPT is linked to liver failure.