This study determined the pattern of alpha-fetoprotein, CD4 + count, albumin, AST, ALT and ALP in HIV positive subjects on long term antiretroviral therapy in NAUTH Nnewi, Anambra State, Nigeria. A total of ninety six (96) participants who were aged between 18 and 60 years attending the voluntary counseling and testing unit (VCT) and antiretroviral therapy unit (ART) of NnamdiAzikiwe University Teaching Hospital (NAUTH), Nnewi were randomly recruited for the study and grouped based on WHO criteria for HIV staging. Six millilitres (6mls) of blood sample were collected from each of the participants in each group and dispensed into EDTA and plain containers in appropriate volumes for the determination of the alpha fetoprotein (AFP), albumin (ALB), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP) and CD4+ count using standard laboratory methods. Results revealed no statistically significant differences in mean AFP levels, AST and ALP activities when compared between HIV positive participants on long term ART, short term ART, and HIV positive subjects not on ART and control groups respectively (p>0.05). Serum albumin concentration and ALT was not significantly different in HIV positive participants on long term ART than in those on short term ART (p>0.05) although serum albumin levels were significantly higher in HIV participants on long term ART and short term ART than in HIV positive subjects not on ART in each case (p<0.05) but was significantly lower in HIV positive participants not on ART compared to control subjects (p<0.05). CD4 + count was significantly higher in HIV positive participants on long term ART when compared with those o short term ART and HIV positive participants not on ART respectively (p<0.05). Therefore, this study has shown improved immune recovery with no hepatotoxicity in HIV positive persons on long term duration of antiretroviral therapy. Importantly, hypoalbuminemia existed among HIV positive subjects not on ART which is suggestive of further progression of the disease.

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