A cross-sectional study of liver function tests in HIV-infected persons in Western India
Journal Title: Medical Journal Armed Forces - Year 2017, Vol 73, Issue 1
Abstract
Background: Derangement of liver function tests (LFTs) is common in people living with human immunodeficiency virus/acquired immune deficiency syndrome (PLHA). The cause is multifactorial. Drug-induced liver injury (DILI) is the commonest cause and others being alcohol abuse and concomitant viral hepatitis. The aim of the research was to study the prevalence of LFT abnormalities in PLHA. Methods: The study was carried out in a tertiary care hospital. Evaluation included a detailed history, thorough clinical examination and investigations including a haemogram, serum biochemistry, serology for hepatitis, and CD4 cell count. Results: A total of 247 patients were evaluated. Of these, 212 (85.82%) were on antiretroviral therapy (ART), 111 (44.93%) were on anti-tubercular therapy (ATT), and 94 (38.05%) were on concurrent ATT–ART. Abnormal LFTs were seen in 128/247 (51.82%) PLHA. In the majority (88.28%), the LFT abnormalities were mild. LFT abnormalities were seen in 109/212 (51.4%) patients on ART, in 56/111 (50.5%) patients on ATT, 46/94 (48.93%) patients on concurrent ART–ATT. There was no difference in LFT abnormalities among the three groups nor was there any significant association with alcohol consumption. There was a statistically significant co-relation between albumin/globulin ratio and CD4 count ( p = 0.0002). Counter-intuitively, LFT abnormalities were commoner in patients not receiving nevirapine ( p = 0.043), but severe abnormalities (grade III/grade IV) were commoner in those receiving nevirapine ( p = 0.005) and in those on concurrent ART–ATT ( p = 0.008). Conclusion: LFT abnormalities in PLHA are common; but usually mild. There is a strong association between severe abnormalities and nevirapine-based therapy ( p = 0.02) and concurrent ATT–ART ( p = 0.008).
Authors and Affiliations
V. K. Sashindran
Keywords
Related Articles
- EP ID EP623764
- DOI 10.1016/j.mjafi.2016.12.004
- Views 78
- Downloads 0
A randomized control trial to assess efficacy of Mifepristone in medical management of uterine fibroid
Background: Fibroids are the most common benign tumours of uterus. Heavy menstrual bleeding is the commonest concern for which medical attention is sought. Hysterectomies for leiomyoma constitute a third of all hysterect...
Lunate dislocation causing median nerve entrapment
Lunate dislocation is an uncommon injury occurring in young adults due to high-energy trauma. The volar displacement of the bone may result in compression of the median nerve within the carpal tunnel and is an uncommon c...
Supraventricular tachycardia requiring repeated cardioversion in a 32-day-old baby
Cardiac arrhythmia is not so uncommon in a young infant but recognition in neonate and infant is not easy. The management of cardiac arrhythmia with cardiogenic shock, nonresponsive to pharmacological cardioversion in a...
Forward surgical care: Emerging issues and challenges.
War strategies have been evolving with time and battlefield casualty care services have been trying to keep pace with the changing demands. Technological advances in the field of trauma care have revolutionised the way i...
Pre-eclampsia: Molecular events to biomarkers
Pre-eclampsia is a hypertensive disorder in pregnancy, which accounts for 10–15% of the maternal and perinatal mortality worldwide. Abnormal placental development and tissue hypoxia are its main etiologic factors. The pr...