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. 2008 May;53(5):1375-82.
doi: 10.1007/s10620-007-9999-6. Epub 2007 Oct 16.

The prevalence and risk factors for abnormal liver enzymes in HIV-positive patients without hepatitis B or C coinfections

Richard K Sterling  1 , Steven Chiu, Kenny Snider, Daniel Nixon
Affiliations

The prevalence and risk factors for abnormal liver enzymes in HIV-positive patients without hepatitis B or C coinfections

Richard K Sterling et al. Dig Dis Sci. 2008 May.

Abstract

Background: Abnormal liver enzymes (LFTs) are frequently seen in HIV patients. Because HCV and HBV overshadow other possible variables, little is known about the prevalence and predictive factors of abnormal LFTs in the absence of viral hepatitis.

Aims: To determine the prevalence and factors associated with abnormal LFTs defined as >1.25 ULN.

Methods: A retrospective analysis of HIV clinic patients was performed. Variables were determined at the time of abnormal LFTs or by history and included diabetes mellitus (DM), hypertension (HTN), dyslipidemia, HCV and HBV status, metabolic syndrome (MS), and HAART use (NRTI, NNRTI, and PI).

Results: Patients without HCV/HBV (n = 679/1,208) were younger, Caucasian, had a BMI >30 and had dyslipidemia. The prevalences of elevated LFTs in those without HCV/HBV were AST 20%, ALT 15%, and ALP 43% compared to 64%, 46%, and 63% in those with HCV (all P < 0.0001), and 98% were mild-moderate (grade 1-2). While AST was highly correlated with ALT, neither was associated with increased ALP. In those without HCV/HBV, increased AST was associated with HTN, HIV RNA, and absence of PI use; increased ALT was associated with HTN, HIV RNA, CD4 < 200, MS, and absence of PI use, while increased ALP was associated with age, BMI, CD4%, DM, and NRTI use.

Conclusions: Mild-moderate increased liver enzymes are common in HIV patients without HCV/HBV and absence of PI use is independently associated with elevations in both AST and ALT, while features typical of hepatic steatosis (DM and BMI) are only associated with increased ALP.

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Conflict of interest statement

No conflicts of interest.

References

    1. Lee LM, Karon JM, Selik R, Neal JJ, Fleming PL. Survival after AIDS diagnosis in adolescents and adults during the treatment era, United States, 1984–1997. JAMA. 2001;285(10):1308–1315. - PubMed
    1. Palella FJ, Jr, Delaney KM, Moorman AC, Loveless MO, Fuhrer J, Satten GA, et al. Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. HIV Outpatient Study Investigators. N Engl J Med. 1998;338(13):853–860. - PubMed
    1. Pol S, Lebray P, Vallet-Pichard A. HIV infection and hepatic enzyme abnormalities: intricacies of the pathogenic mechanisms. Clin Infect Dis. 2004;38 (Suppl 2):S65–S72. - PubMed
    1. Sabin CA. Pitfalls of assessing hepatotoxicity in trials and observational cohorts. Clin Infect Dis. 2004;38 (Suppl 2):S56–S64. - PubMed
    1. Sulkowski MS, Mehta SH, Chaisson RE, Thomas DL, Moore RD. Hepatotoxicity associated with protease inhibitor-based antiretroviral regimens with or without concurrent ritonavir. AIDS. 2004;18(17):2277–2284. - PubMed

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