Liver enzyme elevation in patients taking HAART compared with treatment naïve controls at Debre Berhan Referral Hospital: a comparative cross-sectional study, Northeast Ethiopia

Abstract

ObjectiveHAART had significantly improved the quality of life of HIV patients. However, it results different adverse effects such as: hepatotoxicity, nephrotoxicity, lipodystrophy, anemia, diarrhea, psychiatric disorder and others. Therefore, this comparative cross sectional study was designed to investigate liver enzyme elevation in patients taking HAART compared with treatment naïve controls at Debre Berhan Referral Hospital.ResultA total of 152 individuals (76 cases and 76 controls) were included in this study. The mean ages of treatment and control groups were 37.37 and 36.38 respectively. The mean values of liver enzymes (ALT, AST and ALP), total bilirubin and direct bilirubin were significantly higher (p < 0.05) while, total protein and creatinine were significantly lower in patients taking HAART compared with treatment naïve controls. In this study, about 19 (25%) of clients in HAART treated groups and 7 (9.2%) of treatment naïve controls had showed liver enzyme changes. Moreover, 23.7% and 1.3% of the HAART treated groups developed mild and moderate liver enzyme elevation or hepatotoxicity, respectively. In this study, significant difference was observed in liver enzyme elevation between ART and pre-ART patients. As a result, regular clinical and laboratory monitoring of liver function will be necessary to prevent severe form of liver injury.

Substance Use, Highly Active Antiretroviral Therapy, and Liver Enzymes: Evidence From a Cross-Sectional Study of HIV-Infected Adult Patients Without Comorbidities on HAART in the University of Port Harcourt Teaching Hospital

“…The increase in the enzyme levels of HIV-treatment naïve patients (82) and those on HAART is welldocumented (52)(53)(54)(55). This study noted that the enzyme levels for a large proportion were just slightly above the normal limits; thus, suggesting that majority of the population were within mild to moderate enzyme elevations (54,57). In this study, more patients consumed alcohol than smoking or use of trado-medicine, with no sex-associated difference.…”

“…On the other hand, patients who engage in anti-healthy social behaviors (36)(37)(38)(39) do have poorer outcomes in HIV management (43)(44)(45), and substance abuse is prevalent among people with HIV (67,68). Studies have documented, independently, that HAART (49)(50)(51)(52)(53)(54)(55) and certain social behaviors such as alcohol intake, smoking, and use of herbal remedies (40-42) have significant effects on the liver and may lead to mild to severe liver toxicity, and even death. The increase in the enzyme levels of HIV-treatment naïve patients (82) and those on HAART is welldocumented (52)(53)(54)(55).…”

“…Studies have documented, independently, that HAART (49)(50)(51)(52)(53)(54)(55) and certain social behaviors such as alcohol intake, smoking, and use of herbal remedies (40-42) have significant effects on the liver and may lead to mild to severe liver toxicity, and even death. The increase in the enzyme levels of HIV-treatment naïve patients (82) and those on HAART is welldocumented (52)(53)(54)(55). This study noted that the enzyme levels for a large proportion were just slightly above the normal limits; thus, suggesting that majority of the population were within mild to moderate enzyme elevations (54,57).…”

Longitudinal analysis of new‐onset non‐AIDS‐defining diseases among people living with HIV: A real‐world observational study

“…A previous study showed that PIs could increase the risk of dyslipidemia and myocardial infarction, with a relative rate of 1.13 for cumulative exposure of lopinavir-ritonavir per PY [18]. Patients receiving HAART have significantly higher liver enzyme level compared to treatment-naive HIV-infected patients [19]. All NNRTIs and PIs could cause liver cell damage, whereas the elevated liver transaminase levels would usually improve within 3 months [16,[19][20][21].…”

The Correlated Risk Factors for Severe Liver Damage Among HIV-Positive Inpatients With Abnormal Liver Tests

“…Liver enzyme elevation is common among HIV-infected inpatients, and 50% of these patients are asymptomatic (5). The prevalence of mild and moderate liver enzyme elevations associated with steatosis/steatohepatitis among ART-treated patients was much higher than that among ART-naïve patients, mainly due to increased body mass index (BMI) (6)(7)(8). The liver damage incidence in China was highly observed within 6-12 months after ART initiation (9).…”