Human immunodeficiency virus-1 (HIV) and hepatitis B virus (HBV) co-infection is a major threat, especially to liver damage. 100 female patients referred to Virology department of the Jos University teaching Hospital (JUTH), were selected by physicians on the basis of the following criteria: documented HIV infection, no alcohol abuse (≤ 20 g alcohol daily and no history of chronic alcohol consumption), no history of hereditary and autoimmune liver disease, no evidence of hemochromatosis. Data on demographics, drug or alcohol use, and history of liver diseases were obtained at first visit. A month-by-month documentation of the prescribed drug combination allowed a calculation of each patient's individual cumulative drug exposure. Subjects were then classified into control (30), co-infected; on drugs (35) and co-infected; not on drugs (35). The test for HIV antibodies, HBsAg were carried out on day one (at first visit) serum ALT and serum AST were determined three (3) months after detection (day 90; after HIV antigen confirmatory test). Thirty-five (35) patients started medication at day-one, and 35 decided not to start medication until after confirmatory test (three months later).The serum ALT levels of the HIV-HBV co-infected patients on drugs (M=43.60, SD=1.83) was significantly higher than the serum ALT levels of the control group (M=29.17, SD=6.17), t (63) =12, p< .0001 at p <.05 confidence level. In a similar trend, the serum ALT levels of the HIV-HBV co-infected patients not on drugs (M=37.74, SD=3.70) was significantly higher than the serum ALT levels of the control group (M=29.17, SD=6.17), t (63) =6.5, p< .0001 at p <.05 confidence level. On comparison, the serum ALT levels of the HIV-HBV co-infected patients on drugs (M=43.60, SD=1.83) was significantly higher than the serum ALT levels of the HIV-HBV co-infected patients not on drugs (M=37.74, SD=3.70), t (68) =8.40, p< .0001 at p <.05 confidence level. The serum AST levels of the HIV-HBV co-infected patients on drugs (M=43.54, SD=2.74) was significantly higher than the serum AST levels of the control group (M=32.23, SD=5.93), t (63) =10, p< .0001 at p <.05 confidence level. In a similar manner, the serum AST levels of the HIV-HBV co-infected patients not on drugs (M=37.66, SD=2.11) was significantly higher than the serum AST levels of the control group (M=32.23, SD=5.93), t (63) =5.1, p< .0001 at p <.05 confidence level. On comparison, the serum AST levels of the HIV-HBV co-infected patients on drugs (M=43.54, SD=2.74) was significantly higher than the serum AST levels of the HIV-HBV co-infected patients not on drugs (M=37.66, SD=2.11), t (68) =10.07, p< .0001 at p <.05 confidence level. HIV-HBV infection causes liver damage with more damage caused by drugs taken to manage these infections. A correlation analysis between ALT and AST levels shows a non-significant correlation.

Elevated serum transaminase [alanine aminotransferase (ALT) and aspartate aminotransferase (AST)] levels have been reported in human immunodeficiency virus (HIV)-infected patients on combination antiretroviral therapy (cART). (r = 0.201, p < 0.05).It has been observed from the study that a significant elevation of liver transaminase levels (ALT and AST) is a serious risk factor associated with management of HIV management with drugs.