Incidence of and risk factors for liver damage in patients with HIV‐1 mono‐infection receiving antiretroviral therapy

Abstract

ObjectivesThe study aimed to investigate the incidence of and risk factors for liver damage in patients with human immunodeficiency virus type‐1 (HIV‐1) mono‐infection receiving antiretroviral therapy (ART).MethodsWe retrospectively analyzed the clinical data of patients who were diagnosed with HIV‐1 infection and initiated ART from January to December 2017. Among them, 382 patients with HIV‐1 mono‐infection and normal baseline liver function were included in the analysis. The incidence of liver damage at each follow‐up point, and possible risk factors for liver damage were evaluated via COX regression survival analyses.ResultsThe overall incidence of liver damage (grade I–IV) was 27.23% (interquartile range [IQR]: 26.38%–28.72%). Grade I liver damage was most common and accounted for 22.13% of cases (IQR: 21.06%–24.04%), while grade II liver damage accounted for 3.40% of cases (IQR: 3.19%–4.26%). COX regression and survival analyses revealed that baseline body mass index (BMI), alanine aminotransferase (ALT) level, CD4+ T cell count, HIV‐1 viral load, and the antiretroviral regimen were significantly correlated with the occurrence of liver damage. Moreover, baseline ALT levels and HIV‐1 viral load were identified as independent risk factors for liver damage in patients with HIV‐1 mono‐infection.ConclusionLiver damage is common in patients with HIV‐1 mono‐infection undergoing ART. Patients with risk factors for liver damage should be well‐informed before the initiation of ART, and liver function should be closely monitored during ART even in patients with normal liver function before ART.

CD4/CD8 Ratio Recovered as a Predictor of Decreased Liver Damage in Adults Infected With HIV: 16-Year Observational Cohort Study

“…In this study, liver damage was observed in 20% (491/2440) of the participants, a prevalence in line with earlier studies that reported figures ranging from 12% to 27% [ 19 , 20 ]. However, it is noteworthy that the highest incidence of liver damage reported in this study was 48%, occurring within the initial 3 months following the commencement of cART.…”

“…However, it is noteworthy that the highest incidence of liver damage reported in this study was 48%, occurring within the initial 3 months following the commencement of cART. This rate is both higher and faster than what was observed in a previous study (35% at 9 months) [19]. Nearly half of the patients in this cohort were older adults, aligning with the prevalent demographic trend among patients in Guangxi province [21,22].…”

Incomplete immune reconstitution and its predictors in people living with HIV in Wuhan, China

“…In the present study, a negative correlation was found between TBIL and immune recovery in PLWH. Some study [ 48 , 49 ] found higher HIV RNA and longer duration of HIV viremia were the independent factors to increased risk of HCC, and the presence of liver damage was substantially linked with HIV-1 viral load. While no prior investigation has explicitly illuminated this observation, our supposition is that abnormal liver function could potentially affect the metabolism and absorption of ART drugs, which may decrease treatment efficacy and affect disease progression.…”