Impact of HIV-Infection on Serum Liver Enzymes: A Comparative Study among Anti-retroviral Therapy (ART) Naïve Patients, ART Follow-Up Patients, and HIV Sero-negative Controls

Background of study: There is emerging evidence that human immunodeficiency virus (HIV) infection, even in the absence of anti-retroviral therapy (ART) toxicity and other cofactors, may have a direct impact on liver pathogenesis. Aim: Based on this premise, our study determined the impact of HIV infection on liver enzymes as markers of hepatic function. Methods: the case-control study comprised of a total of 60 participants (30 males and 30 females) aged 18-60 years. The study compared aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), cluster of differentiation (CD4+) cells among ART-naïve HIV patients (n=20), follow-up HIV patients who were on highly active ART (n=20) and apparently healthy controls (n=20). Results: a significant (P<0.05) change was observed in the liver enzymes and CD4+ cells among the study groups compared. Specific changes showed that serum AST, ALP levels of ART-naïve patients were significantly (P<0.05) higher than that of follow-up and controls. Serum ALT levels of controls were significantly (P<0.01) lower than that of ART-naïve and follow-up patients. The CD4+ cell count of ART-naïve patients was significantly (P=0.000) lower than that of follow-up and control groups. Conclusion: Liver enzyme abnormalities were observed in ART naïve HIV infected patients. Consequently, there is a need to monitor liver enzyme levels before and after initiation of therapy.