The prevalence and associated factors for liver enzyme abnormalities among patients with Human Immunodeficiency Virus at St. Paul’s Hospital Millennium Medical College (SPHMMC)

Abstract

Abstract Introduction: Recent trends have shown that liver impairment in Human immune-deficiency virus (HIV)-infected individuals is a frequent and major contributor to non-Aquired Immunodeficiency Syndrome(AIDS)-related morbidity and mortality. Liver disease is often reflected by abnormalities in one of the liver biochemical tests. There are limited studies conducted to identify the magnitude of liver enzyme abnormalities and it’s contributing factors in our country. Objectives: This study aims to assess the prevalence and associated factors for liver enzyme abnormalities among patients with HIV infection on follow-up at St. Paul’s Hospital millennium medical college. Methods: A hospital-based cross-sectional study from April 1 to September 30, 2023 G.C. at St. Paul's Hospital Millennium Medical College's Anti-Retro viral Therapy (ART) follow-up clinic employed medical record reviews and structured interviews. Descriptive and inferential analyses, including multivariable logistic regression for liver disease determinants, were conducted, with significance set at p < 0.05. Results: A total of 386 participants living with HIV infection in this study. We found that the overall prevalence of elevated liver enzymes: either, Alanine Transaminase (ALT) or Asparate Transaminase (AST) or Alakaline phosphatase (ALP) elevation was 26.9% (114/386). Out of the specific liver enzymes, elevated ALT levels, AST levels, and ALP levels was detected among 11.9%, 7.8%, and 17.6% of participants, respectively. Based on multivariable logistic regression analysis, after adjusting for other covarieties, younger age < 44 years, significant alcohol intake, and being on anti-hypertensive medications, were found to have statistically significant association with elevated liver enzymes with a p-value and AOR (95% CI) of (p= 0.046, 1.7(1.01,2.8)), (p= 0.039, 1.8(1.03,3.1)), (P= 0.04, 2.6(1.01,6.3)), respectively. Conclusion: Our study shows that the magnitude of liver enzyme abnormalities among people living with HIV infection is high. Routine assessment and monitoring of liver enzyme abnormalities among people living with HIV infection should be implemented. Key words: HIV, Acquired immunodeficiency virus, Liver disease, Liver cirrhosis, chemical and drug induced liver injury