Transaminase changes in patients infected with human immunodeficiency virus after antiretroviral therapy

Abstract

BACKGROUND: Antiretroviral (ARV) therapy aims to reduce acquired immune deficiency syndrome (AIDS) cases and mortality rates. However, ARVs also have side effects, especially on the liver. Moreover, ARVs must be administered in combination. Since almost all ARVs are metabolized in the liver, it is necessary to monitor transaminase levels. This study analyzed changes in transaminase levels in human immunodeficiency virus (HIV)-infected patients receiving fixed-dose combination (FDC) ARV therapy.METHODS: This prospective observational study was conducted from December 2020 to May 2021 and included HIV-infected patients receiving FDC ARV therapy. Their liver enzyme levels were checked before treatment and again after three weeks or three months of ARV therapy. Their sociodemographic data were collected through a questionnaire and venous blood samples for laboratory testing. Variables were compared using Wilcoxon Test and χ2 test. All results with P<0.05 were considered statistically significant.RESULTS: This study included 62 subjects, of which 52 were male and 10 were female. Thirteen (21%) had hepatitis B or C or tuberculosis coinfections. Their mean aspartate aminotransferase (AST) level was significantly higher after therapy (49.1 U/L) than before (47.9 U/L; P<0.05), a 2.5% increase. In contrast, their mean alanine aminotransferase (ALT) level was significantly lower after therapy (37.5 U/L) than before (51.0 U/L; P<0.05). Their total lymphocyte counts had a significant inverse relationship with ALT levels (P<0.05).CONCLUSIONS: HIV-infected patients receiving FDC ARV had decreased ALT levels and increased AST levels. These findings highlight the importance of continuous and periodic clinical AST monitoring to reduce the risk of developing hepatotoxicity.

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