Drug Hepatotoxicity in HIV Patients on Highly Active Antiretroviral Therapy [HAART] in Southwest Nigeria

Abstract

Abstract: Hepatotoxicity in HIV is associated with anti-retroviral regimens and hepatitis B and C virus coinfection. Altered liver enzymes activities in HIV mono infected patients yet to commence and those on HAART for at least six months were studied. 45 HIV seropositive patients on HAART for at least six months attending LAUTECH Teaching Hospital, Osogbo, Nigeria, 40 newly diagnosed HIV seropositive patients yet to commence HAART (naive) and 40 HIV- negative subjects (control) were recruited. 5 ml venous blood was drawn from each subject. Serum liver function tests were estimated by spectrophotometry. Hepatitis B surface antigen and antibody to hepatitis C virus were determined using ELISA. Data were analyzed statistically and p<0.05 was regarded as significant. Hepatotoxicity was defined using a standardized toxicity grade scale. Total bilirubin, alanine and aspartate aminotransferases (ALT, AST) in HIV-HAART and HIV-naive exceeded the upper limit of normal with lower values recorded in HIV-naïve. There were > 2-fold increase in alkaline phosphatase and AST in HIV-HAART than in controls . Conjugated bilirubin was slightly lower in control subjects than in HIV-HAART and naïve groups. All subjects were negative for HBsAg and anti-HCV. Even in the absence of HAART, mild hepatotoxicity is seen in HIV patients. Keywords: