HEPATOTOXICITY AMONG HIV PATIENTS ON HAART IN ENUGU, ENUGU STATE

AUTHOR: CHUKWUBIKE, CHINEDU MB 

DEPARTMENT: APPLIED MICROBIOLOGY AND BREWING

AFFILIATION: NNAMDI AZIKIWE UNIVERSITY, AWKA

The study assessed hepatotoxicity among HIV patients on Highly Active Antiretroviral Therapy (HAART). Ninety-four (94) HIV/AIDS patients attending the AIDS relief clinic at University of Nigeria Teaching Hospital (UNTH), Ituku-Ozalla, Enugu were enrolled for the study. A questionnaire was administered to each participant to evaluate demographic data and risk factors for hepatotoxicity after obtaining their consent. Pre- treatment and three months post treatment blood samples were collected and distributed into EDTA bottle and plain tubes. The EDTA blood were used to determine the CD4 + T-lymphocyte count of each subject using cyflo partec automated machine. Serum extracted from plain tube blood samples were used to assay for Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) using Enzymelinked Immunosorbent Assay (EIA) 3.0Kit. Markers for liver damage estimated were Alanine aminotransferase (ALT), Aspartate aminotransferase (AST), Total bilirubin (TB) and Direct bilirubin (DB). The questionnaires and laboratory results were analysed using SPSS15.0. A total of 24(25.5%) had grade 1 hepatotoxicity. The toxicity was more in male than female (13.8% vs 11.7, p=0.297 and 0.302 respectively). The age group 27 to 37 years had the highest prevalence of 58.3% (p=0.002).History of alcoholic in-take (p=0.045, Odd Ratio (OR) 2.2, 95% CI=0.883-5.813), having multiple sex partners (p=0.019, OR 3.3, 95% CI = 1.183 – 8.215) and sharing of sharp objects (p=0.041, OR 3.2, 95% CI = 1.013 – 10.091) were significant risk factors for hepatotoxicity. Co-infection with HBV and HCV enhanced hepatotoxicity (p=0.000 and 0.000 respectively). It was observed that CD4 + Tlymphocytes counts were lowered during hepatotoxicity (p=0.000). High levels of AST and ALT in the presence of viral hepatitis co-infection may also predict hepatic toxicity (p=0.000). Hence, centres caring for HIV infected patients should develop strategies for ensuring all HIV infected individuals undergo testing for viral hepatitis and liver function tests before initiation of antiretroviral therapy and rechecking of these every three months for the better management of HIV patients.

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