Liver injury after commencing haart and the effect of baseline CD4 cell count

Abstract

Background: During treatment of HIV disease, a number of factors may influence the effect of the medications used: the presence and/or treatment of viral hepatitides, opportunistic infections, alcoholism, the use of various recreational drugs, immune reconstitution and/or the presence or emergence of diabetes and dyslipidemia which can adversely affect liver injury. The effect of CD4 cell count on liver injury after commencing HAART varies between cohorts. This study aims to determine the type of liver injury after commencing HAART in HIV infected patients and the effect of baseline CD4 cell count. Method: This study was carried out on patients with HIV on HAART attending infectious disease clinic, gastroenterology clinic or admitted into the medical wards of the University of Benin Teaching Hospital. Patients with HIV but not on HAART were used as controls. A clinical evaluation and relevant laboratory investigations were done. Hepatotoxicity was defined using a standardized toxicity grade scale. Results: A total of 84 cases and 42 controls were studied. The mean ages were 35.2΁ 9.9years and 35.5΁9.0years for the cases and the controls respectively. Over 70% of the study population and controls were females. The overall incidence of hepatotoxicity was 17.9% and severe hepatotoxicity occurred in 10.7% of the patients. Liver injury after commencing HAART in this study was 100% cytotoxic and was not affected by baseline CD4 Cell Count. Conclusion: This study shows that Liver injury associated with usa of HAART in HIV patients is cytotoxic and unaffected by baseline CD4 Cell Count.

Keywords

• Liver injury
• HAART
• Baseline CD4