Liver Enzymes and HIV-infected Adults on HARRT: Evidence from a Randomised Cross-sectional Study in UPTH

Abstract

This study evaluated the liver enzyme levels of HIV-infected adult patients on highly active antiretroviral treatment (HAART) for not less than 1 year. The study was designed as a randomised cross-sectional study that evaluated the differences in the aspartate aminotransferase [AST], alanine transaminase [ALT] and alkaline phosphatase [ALP] of 129 (46 males and 83 females) HIV-infected adult patients. Before the study, ethical clearance (Ref: UPH/CEREMAD/REC/19) was obtained from the University of Port Harcourt Ethics Committee. Venous blood samples were obtained and the liver enzyme levels were analysed using Clinical Chemistry Analyser (VS10) manufactured by Vitro Scient. Values were further categorised into; normal or abnormal. SPSS version 21 (IBM® Armonk, USA) and Graph Pad Prism (Version 8.0.2) was used to analyse the data. T-test compared the sex differences in mean, while Chi-square analysis tested the sex differences in the categorised data. From the result, the mean AST (27.65±17.93 IU/L) and ALP (135.13±10.87 IU/L) values for males were higher than females AST (27.25±18.93 IU/L) and ALP (132.65±9.96 IU/L) values, while ALT was higher in female (34.66±22.29 IU/L) than males (33.75±18.14 IU/L); however, the differences were not significant (p>0.05). Generally, abnormal AST, ALT and ALP levels were 31%, 34% and 82% respectively; with no sex-associated differences (p>0.05). 45.7% of the patients (males: 25 [54.3%] and females: 34 [41.0%]) had cholestatic abnormality, while 8.5% (5; 10.9% males and 6; 7.2% females) had hepatocellular abnormality, 18.6% (6; 13.0% of males and 18; 21.7% of females) and mixed abnormality (AST/ALT/ALP). The correlation between CD4 count and liver enzymes were not significant (P>0.05). In conclusion, cholestatic abnormalities were observed in more than 80% of the patients as opposed to hepatocellular abnormalities, which were less than 35%. More females were associated with mixed abnormality when compared to males with independent (ALT/AST) abnormality. This study, therefore, suggests the need for a randomised case-control study to highlight the extent of deviation from normal values.