Prevalence and risk factors for hepatotoxicity among patients with HIV/AIDS on highly active antiretroviral therapy in North-Western Nigeria

Hamza, Muhammad; Adamu, S; Maifada, Yakasai Ahmad; Babashani, Musa; Nalado, Aisha M.; Mijinyawa, Muhammad Sani; Muhammad, Borodo Musa; Garba, Habib Abdulrazaq

doi:10.4103/2384-5147.144727

Cited by 6 publications

(17 citation statements)

References 2 publications

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“…This is consistent with previous study ﬁndings reported from Nigeria and Ethiopia. 13 , 18 In contrast to our finding, previous investigators have reported lower hepatotoxicity at baseline, 22 , 23 which might be related to the fact that involvement of the immune system during infection could result in damage to liver cells (hepatocellular) by autoimmune diseases. In contrast, enhanced immunity could also decrease opportunistic infections at the beginning of HIV infection, contributing to the reduction of liver enzymes.…”

Section: Discussioncontrasting

confidence: 99%

“…[17][18][19] However, the current study result is contradictory with a similar study reported in Nigeria. 13 The high prevalence of toxicity in Nigeria might have resulted from including a high number of participants who were using traditional/herbal medicines, which were excluded from the current study. A study reported from Uganda also showed lower hepatotoxicity than the current studyat the baseline among patients initiating HAART.…”

Section: Discussionmentioning

confidence: 99%

“… 12 Moreover, studies also fail to demonstrate a consistent magnitude of severe hepatotoxicity occurring in HAART-experienced and naive individuals. 13 Although many people living with HIV are on HAART in Ethiopia, there is limited evidence on the incidence and risk factors for hepatotoxicity in people living with HIV to support patients’ care and treatment management. Thus, this study aimed to determine the incidence and risk factors for hepatotoxicity in people living with HIV and on HAART in Ethiopia.…”

Section: Introductionmentioning

confidence: 99%

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Incidence of Hepatotoxicity and Factors Associated During Highly Active Antiretroviral Therapy in People Living with HIV in Ethiopia: A Prospective Cohort Study

Gebremicael¹,

Tola²,

Gebreegziaxier³

et al. 2021

HIV

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Introduction Hepatotoxicity is one of the risk factors associated with treatment non-adherence, which is the main risk factor for drug resistance. Therefore, this study aimed to determine the incidence and risk factors of hepatotoxicity during highly active antiretroviral therapy (HAART) among people living with HIV in Ethiopia. Methods A prospective cohort study was conducted between April 2007 and January 2011 at Saint Peter Specialized Hospital, Akaki and Kality Health Centers, Addis Ababa, Ethiopia. A total of 316 HIV-infected adult individuals (70 participants were HIV and TB co-infected and 246 were infected with HIV alone) were included in this study. The study participants were followed for a total of 18 months with or without HAART. Socio-demographic data were collected using a structured questionnaire, and venous blood samples were collected for laboratory tests. Logistic regression and Poisson regression were used to determine the independent effect of each variable on hepatotoxicity at baseline and end of follow-up. Results Of 316 HIV-infected people, 72 (22.8%) participants had an elevated ALT/AST which was 100% mild-to moderate hepatotoxicity at baseline. Baseline CD4 T-cell count ( p = 0.027) and HIV co-infection with TB ( p < 0.001) were independently associated with hepatotoxicity at baseline. The overall incidence rate of hepatotoxicity in participants on HAART (21.8 per 100 person-years) was lower than participants who were HAART naïve (33.3 per 100 person-years) ( p = 0.009). Conclusion High incidence of mild-to-moderate hepatotoxicity and low severe hepatotoxicity were observed in HIV-infected individuals who were on HAART or were HAART naïve. HAART may minimize the occurrence of hepatotoxicity. Although HAART could minimize hepatotoxicity among HIV-infected people, to manage mild and moderate hepatotoxicity liver function test monitoring is required.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Incidence of Hepatotoxicity and Factors Associated During Highly Active Antiretroviral Therapy in People Living with HIV in Ethiopia: A Prospective Cohort Study

Gebremicael¹,

Tola²,

Gebreegziaxier³

et al. 2021

HIV

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“…In the United States, nearly 2000 cases of acute liver failure occur annually, and drugs account for over 50% of them [1]. Abnormalities of liver enzymes are found both in human immunodeficiency virus (HIV) and antiretroviral therapy (ART) [2][3][4][5][6]. In addition, anemia and hyperglycemia were depicted in HIV and ART [7][8][9][10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Derangement of Liver Enzymes, Hyperglycemia, Anemia, and Associated Factors among HIV-Infected Patients Treated with Tenofovir Disoproxil Fumarate-Based Regimen in Ethiopia: A Prospective Cohort Study

Yazie

2021

BioMed Research International

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Hepatotoxicity was found in different case reports and studies in tenofovir disoproxil fumarate- (TDF-) based regimen. However, there was no data regarding liver enzymes, glucose, and hemoglobin in Ethiopian patients receiving TDF-based regimen. The aim of this study was to determine elevated liver enzymes and its associated factors as well as elevated fasting plasma glucose and anemia. A hospital-based observational prospective cohort study was conducted on conveniently selected 63 patients in Tikur Anbessa Specialized Hospital (TASH) from January to September 2019. Laboratory values were determined at pre-TDF-based regimen baseline and six-month follow-up. The data was analyzed by using SPSS version 21.0, and multivariate logistic regression was used to determine associated factors with elevated liver enzymes. The overall elevated liver enzymes were found in 26 (41.3%) participants. From this, elevated alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase (ALP) comprise 3 (4.8%), 3 (4.8%), and 20 (31.8%), respectively. Elevated fasting plasma glucose (FPG) was found in 9 (14.3%) and 14 (22.2%) of participants at baseline and six-month visit, respectively. At six-month visit, 4 (6.4%) of participants experienced anemia. The mean value of ALP and FPG at six months was significantly higher than their respective baseline mean values ( mean difference MD = + 63.38 , 95% CI (39.84, 86.92), p = 0.0001 ; MD = + 6.64 , 95% CI (2.63, 10.64), p = 0.002 , respectively). The mean value of ALT, AST, and Hg at six months was slightly increased compared to their respective baseline mean values, but the difference was not significant. In multivariate analysis, only female sex was significantly associated with elevated ALP ( AOR = 4.5 , 95% CI (1.03, 19.6), p = 0.045 ). Overall mild and moderate hepatotoxicity was found to be high (26, 41.3%) in the present study, and from this, the majority was comprised by elevated ALP (20, 31.8%). The proportion of participants with hyperglycemia was increased at the end of follow-up compared to its baseline value, but anemia was not. Female sex was significantly associated with elevated ALP. This study warrants monitoring of liver enzymes and glucose in TDF-based regimen.

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“…Acquired Immunodeficiency Syndrome (AIDS) is a clinical syndrome caused by Human Immunodeficiency Virus (HIV) that has caused many deaths in various countries and it is estimated that 34 million people worldwide had been infected with HIV by the end of 2011 (Kanta, 2011;Hamza M, 2014). The morbidity and mortality of HIV decreases significantly after introduction of antiretroviral therapy (ART).…”

Section: Introductionmentioning

confidence: 99%

The Correlation of Initial CD4 Cell Count with Increased Alanine Aminotransferase in Patients with Human Immunodeficiency Virus Who Have Received Nevirapine

Rokhim

Hadi

Triyono

2017

Proceedings of Surabaya International Physiology Seminar

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Nevirapine is one of the most widely used antiretroviral drugs in developing countries. One of the current concerns is the high risk of hepatotoxicity associated with the use of Nevirapine in about 6-30% of patients and is the cause of discontinuation of antiretroviral therapy in 2-10% of patients due to severe liver disorders characterized by increased alanine aminotransferase (ALT). Hepatotoxicity in people with Human Immunodeficiency Virus (HIV) can be caused by many factors. Two mechanisms of nevirapine hepatotoxicity have been proposed. One of mechanisms is the immune-mediated hypersensitivity reaction that induces hepatotoxicity reactions that are thought to be associated with early CD4 counts. The aim of this study was to determine the correlation between initial CD4 count and elevated ALT levels in people infected with HIV who have received nevirapine for 3 months. This study was cross-sectional observational analytic research of 30 HIV-infected patients receiving nevirapine treatment. Each patient was assessed for initial CD4 cell count and initial ALT levels before receiving nevirapine treatment. After 3 months of nevirapine treatment, ALT re-examination was performed to determine elevated alanine aminotransferase levels, then correlation analysis was performed using Spearman's test. Spearman's correlation test results found a negative correlation between initial CD4 count and elevated ALT levels but not was statistically significant (r =-0.107; p = 0.573). In the sub analysis, a positive correlation was found between initial ALT level and ALT level increase (r = 0.427; p = 0.019). Initial CD4 count was not correlated with elevated ALT levels in HIV-infected patients receiving Nevirapine-based ARVs.

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Prevalence and risk factors for hepatotoxicity among patients with HIV/AIDS on highly active antiretroviral therapy in North-Western Nigeria

Cited by 6 publications

References 2 publications

Incidence of Hepatotoxicity and Factors Associated During Highly Active Antiretroviral Therapy in People Living with HIV in Ethiopia: A Prospective Cohort Study

Incidence of Hepatotoxicity and Factors Associated During Highly Active Antiretroviral Therapy in People Living with HIV in Ethiopia: A Prospective Cohort Study

Derangement of Liver Enzymes, Hyperglycemia, Anemia, and Associated Factors among HIV-Infected Patients Treated with Tenofovir Disoproxil Fumarate-Based Regimen in Ethiopia: A Prospective Cohort Study

The Correlation of Initial CD4 Cell Count with Increased Alanine Aminotransferase in Patients with Human Immunodeficiency Virus Who Have Received Nevirapine

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