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Liver function test abnormalities in a longitudinal cohort of Thai individuals treated since acute HIV infection
- Source :
- Journal of the International AIDS Society, Journal of the International AIDS Society, 23(1):e25444. International AIDS Society
- Publication Year :
- 2020
- Publisher :
- Wiley, 2020.
-
Abstract
- Introduction Liver disease is a common cause of non‐AIDS morbidity and mortality in people living with HIV (PLHIV), but the prevalence and significance of liver function test (LFT) abnormalities in early HIV infection is unknown. This study aimed to characterize LFTs in a large cohort of participants with acute HIV infection initiating immediate antiretroviral therapy (ART) and examine the association between LFTs and biomarkers of HIV infection and inflammation. Methods We measured LFTs at the time of HIV diagnosis and at 4, 12, 24 and 48 weeks after ART initiation in 426 Thai individuals with acute HIV infection from 2009 to 2018. A subset of individuals had data available at 96 and 144 weeks. We excluded individuals with concomitant viral hepatitis. Alanine aminotransferase (ALT) was the primary outcome of interest; values greater than 1.25 times the upper limit of normal were considered elevated. Analyses utilized descriptive statistics, non‐parametric tests and multivariate logistic regression. Results Sixty‐six of the 426 individuals (15.5%) had abnormal baseline ALT levels; the majority (43/66, 65.5%) had Grade 1 elevations. Elevated baseline ALT correlated with Fiebig stages III to V (p = 0.001) and baseline HIV RNA >6 log10 copies/mL (p = 0.012). Baseline elevations resolved by 48 weeks on ART in 59 of the 66 individuals (89%). ALT elevations at 24 and 48 weeks correlated with Fiebig stages I to II at diagnosis (p 350 cells/μL (p = 0.03) and older age (p = 0.03). Individuals initiating efavirenz‐based regimens were more likely to have elevated ALT levels at 48 weeks compared with those on non‐efavirenz‐based regimens (p = 0.003). Conclusions One in six people with acute HIV infection have elevated LFTs. Clinical outcomes with ART started in acute HIV are generally good, with resolution of ALT elevations within 48 weeks on ART in most cases. These results suggest a multifactorial model for hepatic injury involving a combination of HIV‐associated and ART‐associated processes, which may change over time.
- Subjects :
- Adult
Cyclopropanes
Male
medicine.medical_specialty
Efavirenz
Human immunodeficiency virus (HIV)
HIV Infections
medicine.disease_cause
Logistic regression
Cohort Studies
Young Adult
03 medical and health sciences
Liver disease
chemistry.chemical_compound
0302 clinical medicine
Internal medicine
medicine
Humans
030212 general & internal medicine
Research Articles
Acute HIV infection
Acquired Immunodeficiency Syndrome
030505 public health
medicine.diagnostic_test
business.industry
Liver Diseases
anti‐HIV agents
Public Health, Environmental and Occupational Health
HIV
Alanine Transaminase
Thailand
medicine.disease
antiretroviral agents
Benzoxazines
3. Good health
acute HIV
Infectious Diseases
anti-HIV agents
chemistry
Alkynes
Concomitant
Female
liver function tests
0305 other medical science
Viral hepatitis
business
Liver function tests
Research Article
Subjects
Details
- ISSN :
- 17582652
- Volume :
- 23
- Database :
- OpenAIRE
- Journal :
- Journal of the International AIDS Society
- Accession number :
- edsair.doi.dedup.....8abd7315525295e346ccf5eb25d6d8ca