Rate of liver damage in HIV patients and potential risk factors

The rate of liver damage in HIV patients due to combinational ARVs (Anti-Retroviral Therapies) is lower in the Bali hospital district, Cameroon, compared to previous studies. However, gender, consumption of alcohol and smoking influences the risk for liver damage in HIV patients. 

Sub-Saharan Africa represents more than half of the HIV cases worldwide. Combinational HIV drugs are the recommended treatment, however its effects cause liver damage in patients. Not many studies focus on liver damage by ARVs however, so more data on this is needed.

The scientists wanted to find out how many people in the area were HIV positive with liver damage. They also wanted to find out which lifestyle habits increase the risk of liver damage in these patients. 

The researchers studied Bali district hospital patients who were HIV positive and older than 18 years. Blood samples were collected from all patients, and they checked if certain proteins that are linked to liver damage were present or not. They then used computer modelling to predict which lifestyle factors are linked to liver damage.

The researchers confirmed that the levels of proteins that indicate liver damage were higher in HIV positive patients. Their work also showed how certain HIV treatments were linked to higher levels of these proteins. Their computer modelling revealed that men who take ARVs are at a higher risk of liver damage, as well as people who consume alcohol and smoke.

It was already known that HIV positive patients have a risk of liver damage because of the treatments that they take. However, this study looked at the rate at which HIV patients experience liver damage at the Bali District Hospital. The researchers also found that drinking alcohol and smoking puts HIV patients at a higher risk for liver damage. 

The researchers caution that patient data may be a limitation in this study. They didn’t consider all factors, such as the use of other drugs besides HIV treatments. 

Also, since the population used for this study was different from other studies in terms of age and sex, the conclusions don’t necessarily agree with other studies from Africa.

This study focused on one hospital in Cameroon and the findings should be confirmed in future research in other regions. 

Africa has a high burden of HIV. This study by Cameroonian researchers sheds light on important data showing the incidence of liver damage in HIV patients, and the different factors increase their risk for liver damage. Having this information may help in the management of liver damage in HIV patients. 

Abstract

Introduction The incidence of hepatotoxicity is life-threatening and can result to an end-stage liver disease in long-term patients on combined antiretroviral therapy (cART). Our study sought to evaluate the incidence and predictors of cART-induced hepatotoxicity (CIH) among long term users on cART in a rural District hospital.

Methods This was a hospital-based cross-sectional study in the Bali District Hospital. Spectrophotometric method was use for the quantitative measurement of alanine-aminotransferase (ALT) and aspartate-aminotransferase (AST) levels. Patients with elevations of both ALT and AST were considered CIH. The Chi (χ2) square test, ANOVA and Kaplan Meier log-ranked/ survival analyses were used to analyse the data.

Results Of the 350 participants enrolled [156 (44.6%) males and 194 (55.4%) females], aged 43.87 ± 0.79 years (range 20 – 84 years) included in this analysis, 26 (4.4%) experienced moderate CIH. We observed 57 (16.3%), 62 (17.7%) and 238 (68%) elevated levels ALT + AST, ALT and AST respectively. Two independent predictive factors of CIH were, the male sex and alcoholism during the study period.

Conclusion The prevalence of CIH in HIV-infected patients in Bali was lower than that observed in previous studies. The duration of therapy had no influence on the frequency of CIH. Alcoholism and smoking showed significant differences in the development of CIH.

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