Risk factors of severe hepatotoxicity among HIV-1 infected individuals initiated on highly active antiretroviral therapy in the Northwest Region of Cameroon.
Adolescent
Adult
Anti-HIV Agents
/ adverse effects
Antiretroviral Therapy, Highly Active
/ adverse effects
Cameroon
/ epidemiology
Chemical and Drug Induced Liver Injury
/ drug therapy
HIV Infections
/ drug therapy
HIV-1
Humans
Lamivudine
/ adverse effects
Male
Middle Aged
Risk Factors
Young Adult
Zidovudine
/ adverse effects
HAART
HIV-1
Hepatotoxicity
Liver enzymes
Risk factors
Journal
BMC gastroenterology
ISSN: 1471-230X
Titre abrégé: BMC Gastroenterol
Pays: England
ID NLM: 100968547
Informations de publication
Date de publication:
03 Jun 2022
03 Jun 2022
Historique:
received:
21
05
2021
accepted:
11
03
2022
entrez:
6
6
2022
pubmed:
7
6
2022
medline:
9
6
2022
Statut:
epublish
Résumé
Hepatotoxicity due to highly active antiretroviral therapy (HAART) has gained prominent attention since it can be affected by many factors. The aim of this study was to determine the prevalence of hepatotoxicity and related risk factors of severe hepatotoxicity following HAART initiation. A total of 100 drug-naive patients aged between 18 and 61 years were recruited. They were put on Tenofovir/Lamivudine/Efavirenz [TDF/3TC/EFV] (64), Zidovudine/ Lamivudine/Efavirenz [AZT/3TC/EFV] (22), and Zidovudine/Lamivudine/Nevirapine AZT/3TC/NVP (14) and monitored for 6months and blood samples drawn.Alanine aminotransferases (ALT), aspartate aminotransferases (AST), and alkaline phosphatase (ALP) wereanalyzed by enzymatic methods and used to classify levels of hepatotoxicity. A total of 37(37%) and 49(49%) patients presented with hepatotoxicity while 15% and 28% had severe hepatotoxicity at 4 and 24 weeks respectively. Serum levels of all enzymes increased significantly (p = 0.001) with increased treatment duration. Univariate analysis revealed that the risk factor of developing severe hepatotoxicity was significantly greater in patients < 30years (p = 0.02), males(p = 0.04), low BMI (p = 0.02), low monthly income (p = 0.01) earners, and patients on AZT + 3TC + NVP regimen (p = 0.01). While multivariate analysis at p < 0.09 showed that age 30-40 years, low BMI, low monthly income, and the use of AZT + 3TC + NVP regimen were independent risk factors. Low BMI, age group of 30-40years, low monthly income, and the use of AZT + 3TC + NVP regimen identified as risk factors for the development of severe hepatotoxicity should be considered as an important strategy by clinicians in preventing the hepatotoxicity.
Sections du résumé
BACKGROUND
BACKGROUND
Hepatotoxicity due to highly active antiretroviral therapy (HAART) has gained prominent attention since it can be affected by many factors. The aim of this study was to determine the prevalence of hepatotoxicity and related risk factors of severe hepatotoxicity following HAART initiation.
METHODS
METHODS
A total of 100 drug-naive patients aged between 18 and 61 years were recruited. They were put on Tenofovir/Lamivudine/Efavirenz [TDF/3TC/EFV] (64), Zidovudine/ Lamivudine/Efavirenz [AZT/3TC/EFV] (22), and Zidovudine/Lamivudine/Nevirapine AZT/3TC/NVP (14) and monitored for 6months and blood samples drawn.Alanine aminotransferases (ALT), aspartate aminotransferases (AST), and alkaline phosphatase (ALP) wereanalyzed by enzymatic methods and used to classify levels of hepatotoxicity.
RESULTS
RESULTS
A total of 37(37%) and 49(49%) patients presented with hepatotoxicity while 15% and 28% had severe hepatotoxicity at 4 and 24 weeks respectively. Serum levels of all enzymes increased significantly (p = 0.001) with increased treatment duration. Univariate analysis revealed that the risk factor of developing severe hepatotoxicity was significantly greater in patients < 30years (p = 0.02), males(p = 0.04), low BMI (p = 0.02), low monthly income (p = 0.01) earners, and patients on AZT + 3TC + NVP regimen (p = 0.01). While multivariate analysis at p < 0.09 showed that age 30-40 years, low BMI, low monthly income, and the use of AZT + 3TC + NVP regimen were independent risk factors.
CONCLUSIONS
CONCLUSIONS
Low BMI, age group of 30-40years, low monthly income, and the use of AZT + 3TC + NVP regimen identified as risk factors for the development of severe hepatotoxicity should be considered as an important strategy by clinicians in preventing the hepatotoxicity.
Identifiants
pubmed: 35658835
doi: 10.1186/s12876-022-02305-x
pii: 10.1186/s12876-022-02305-x
pmc: PMC9166462
doi:
Substances chimiques
Anti-HIV Agents
0
Lamivudine
2T8Q726O95
Zidovudine
4B9XT59T7S
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
286Informations de copyright
© 2022. The Author(s).
Références
Afr Health Sci. 2011 Mar;11(1):16-23
pubmed: 21572852
JAMA. 2000 Jan 5;283(1):74-80
pubmed: 10632283
PLoS One. 2013 May 07;8(5):e63439
pubmed: 23667618
BMC Gastroenterol. 2012 Oct 18;12:145
pubmed: 23075166
Dig Dis Sci. 2008 May;53(5):1375-82
pubmed: 17939038
Ann Clin Biochem. 1996 Nov;33 ( Pt 6):530-5
pubmed: 8937584
Clin Gastroenterol Hepatol. 2010 Dec;8(12):1002-12
pubmed: 20851211
PLoS One. 2012;7(7):e40180
pubmed: 22808112
PLoS One. 2010 Feb 17;5(2):e9183
pubmed: 20174653
J Gastroenterol Hepatol. 2008 Jul;23(7 Pt 1):1089-93
pubmed: 18557801
Crit Rev Clin Lab Sci. 2005;42(3):197-227
pubmed: 16047538
Ann Clin Biochem. 2010 Jul;47(Pt 4):321-6
pubmed: 20511375
Alcohol Res Health. 2010;33(3):229-36
pubmed: 23584064
Ethiop J Health Sci. 2013 Nov;23(3):217-26
pubmed: 24307821
HIV AIDS (Auckl). 2012;4:117-24
pubmed: 22893751
Osong Public Health Res Perspect. 2017 Apr;8(2):124-129
pubmed: 28540156
World J Gastroenterol. 2006 Oct 14;12(38):6098-101
pubmed: 17036378
PLoS One. 2015 Aug 06;10(8):e0134449
pubmed: 26247879