Alterations of Serum Transaminases in HIV patients on ART

Abstract

Introduction: Elevation of liver enzymes is a sensitive signal of drug induced liver injury in HIV patients receiving Antiretroviral Therapy (ART). Studies reporting severe hepatotoxicity due to the administration of ART are available. Some researchers suggest that elevation of transaminases is not a major concern while treating HIV. Aim: To compare transaminase levels of HIV patients on ART as compared to HIV patients who are yet to start ART (preART) and non- HIV individuals. Materials and Methods: A retrospective observational study on 80 non- HIV subjects (group I), 100 adult HIV patients who are yet to start ART (pre-ART) (group II) and 100 HIV patients on different ART regimens for 6 months (group III) was carried out in a medical college teaching hospital. Patients’ data like demographic profile, CD4 counts are collected from their medical records. Transaminases values were noted down from the clinical biochemistry laboratory. Statistical analysis was done by One way ANOVA followed by a post hoc test to compare liver enzymes between different groups. Correlation study is done using Pearson’s correlation coefficient. Results: Transaminase levels were significantly high (p<0.0001) in HIV patients on ART as compared to other groups. Pearson’s correlation study showed a significant negative correlation between age and transaminases in group III (p=0.021 for AST, p=0.039 for ALT). Conclusion: The present study suggests that ART regimens might be responsible for elevation of transaminases in HIV patients. However, elevation of liver enzymes is not a major concern as extent of elevation was small and ART patients showed significant improvement in CD4 counts after receiving therapy.

Keywords

• adverse drug reactions
• liver enzymes
• opportunistic infections