Correlation between HIV viral load and aminotransferases as liver damage markers in HIV infected naive patients: a concordance cross-sectional study

Abstract

Abnormalities in liver function tests could be produced exclusively by direct inflammation in hepatocytes, caused by the human immunodeficiency virus (HIV). Mechanisms by which HIV causes hepatic damage are still unknown. Our aim was to determine the correlation between HIV viral load, and serum levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) as markers of hepatic damage in HIV naive infected patients. We performed a concordance cross-sectional study. Patients with antiviral treatment experience, hepatotoxic drugs use or co-infection were excluded. We used a Pearson's correlation coefficient to calculate the correlation between aminotransferases serum levels with HIV viral load. We enrolled 59 patients, 50 men and 9 women seen from 2006 to 2008. The mean (+/- SD) age of our subjects was 34.24 +/- 9.5, AST 37.73 +/- 29.94 IU/mL, ALT 43.34 +/- 42.41 IU/mL, HIV viral load 199,243 +/- 292,905 copies/mL, and CD4+ cells count 361 +/- 289 cells/mm(3). There was a moderately strong, positive correlation between AST serum levels and HIV viral load (r = 0.439, P < 0.001); and a weak correlation between ALT serum levels and HIV viral load (r = 0.276, P = 0.034); after adjusting the confounders in lineal regression model the correlation remained significant. Our results suggest that there is an association between HIV viral load and aminotransferases as markers of hepatic damage; we should improved recognition, diagnosis and potential therapy of hepatic damage in HIV infected patients.

Drug Hepatotoxicity in HIV Patients on Highly Active Antiretroviral Therapy [HAART] in Southwest Nigeria

“…The observed elevation in the serum transaminases in sero-positive patients in this study may be caused by the HIV infection itself or be as a result of the presence of opportunistic infections which stimulates an immunological response by hepatic phagocytes against the infection [3]. This is further supported by another study which reported that apart from HAART-derived hepatotoxicity, some liver diseases are often associated with HIV infection leading to increased transaminases [16].…”

“…These include suspected hepatotoxicity related to highly active antiretroviral therapy regimen, immune allergic mechanisms [2], or by the HIV itself influencing a direct damage on the hepatic cells leading to apoptosis and mitochondrial dysfunction of hepatic cells [3].…”

Risk factors for liver fibrosis among human immunodeficiency virus monoinfected patients using the FIB4 index in Morocco

“…Our study found that HIV viremia was a risk factor for significant liver fibrosis among HIV monoinfected patients. Previous studies identified HIV RNA as an independent factor of elevated AST and ALT in HIV monoinfected patients [6,17] . HIV viremia was also associated with a high FIB4 index score in HIV-HVC co-infected patients [18] .…”

“…Moreover, recent data suggest a direct role of HIV virus in hepatic fibrosis [3][4][5] . Studies carried out in HIV monoinfected patients found a mild to moderate increase in liver enzymes [6][7][8][9][10][11][12][13][14][15][16][17] . Indirect data indicate a possible direct role of HIV virus in liver damage and fibrosis.…”

Coinfections of Human Immunodeficiency Virus and Sexually Transmitted Infections among HIV Seropositive Pregnant Women at Healthcare Centres in Akure, Southwestern Nigeria

“…We also noted abnormal high titers of ALT of 59 -75 IU/L, creatinine at 43-50mg/dL and total bilirubin of 11-35mg/ dL at both antenatal and postnatal periods. These high values in Table 4 are indicative of progressive liver damage [19,20,21]. Analysis of the profile of the four others with three HIV-HBV-TV coinfections showed a mean CD4+ T cell count of 314.75 cells/ mm 3 compared to 405.3 cells/mm 3 for three individuals with only HIV-HBV coinfection.…”