Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jun 3;22(1):286.
doi: 10.1186/s12876-022-02305-x.

Risk factors of severe hepatotoxicity among HIV-1 infected individuals initiated on highly active antiretroviral therapy in the Northwest Region of Cameroon

Lem Edith Abongwa  1   2   3 , Anthony Kebira Nyamache  4 , Fokunang Charles  5 , Judith Torimiro  6   5 , Nshom Emmanuel  7 , Irénée Domkam  6 , Mbu Eyongetah  8 , Beriyuy Jude  9 , Fung Holgar Mua  10 , Sama Bella  10 , Tankou Colman Tamboh  11 , Erna Charlene Moungang  12 , Victorine Ngum  12 , Paul Okemo  4
Affiliations

Risk factors of severe hepatotoxicity among HIV-1 infected individuals initiated on highly active antiretroviral therapy in the Northwest Region of Cameroon

Lem Edith Abongwa et al. BMC Gastroenterol. .

Abstract

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: 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: 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: 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.

Keywords: HAART; HIV-1; Hepatotoxicity; Liver enzymes; Risk factors.

PubMed Disclaimer

Conflict of interest statement

We declare that we have no competing interests.

Figures

Fig. 1
Fig. 1
Prevalence (%) of hepatotoxicity grade with respect to duration
Fig. 2
Fig. 2
Variation of mean ALT, AST and ALP during the study period
See this image and copyright information in PMC

References

    1. USAIDS: Global AIDS Update http://www.unaids.org/en/resources/documents. 2016. Assessed on the 13/01/17.
    1. Osakunor D, Obirikorang C, Fianu V, Asare I, Dakorah M. Hepatic enzyme alterations in HIV patients on antiretroviral therapy: A Case-Control Study in a Hospital Setting in Ghana. PLOS ONE. 2015;10:e0134449. doi: 10.1371/journal.pone.0134449. - DOI - PMC - PubMed
    1. Wambani JR, Ogola PE, Arika WM, Rachuonyo HO, Kemboi NG, Lihana R, et al. Anti-retroviral drug hepatotoxicity and risk factors in HIV patients with or without hepatitis B and C: a review. J Infect Dis Ther. 2015;3:258.
    1. Wenderlein D, Scarcella P. Antiretroviral treatment-associated hepatotoxicity and anemia in patients receiving stavudine or zidovudine containing regimens in Sub- Saharan African Settings. J AIDS Clin Res. 2016;07(01).
    1. Kalyesubula R, Kagimu M, Opio KC, Kiguba R, Semitala CF, Schlech WF, et al. Hepatotoxicity from first line antiretroviral therapy: an experience from a resource limited setting. Afr Health Sci. 2011;11:16–23. - PMC - PubMed

MeSH terms