Predictors of severe hepatotoxicity among retroviral infected adults on HAART regimen in Ilubabor Zone, Southwest Ethiopia.

Publisher: Nature Publishing Group Country of Publication: England NLM ID: 101563288 Publication Model: Electronic Cited Medium: Internet ISSN: 2045-2322 (Electronic) Linking ISSN: 20452322 NLM ISO Abbreviation: Sci Rep Subsets: MEDLINE

Original Publication: London : Nature Publishing Group, copyright 2011-

HIV Infections*/complications ; HIV Infections*/drug therapy ; HIV Infections*/epidemiology ; Coinfection* ; Hepatitis C*/drug therapy ; Liver Diseases*/etiology ; Tuberculosis*/drug therapy ; Drug-Related Side Effects and Adverse Reactions*/etiology ; Digestive System Diseases*/drug therapy ; Chemical and Drug Induced Liver Injury*/epidemiology ; Chemical and Drug Induced Liver Injury*/etiology ; Chemical and Drug Induced Liver Injury*/drug therapy; Adult ; Humans ; Antiretroviral Therapy, Highly Active/adverse effects ; Ethiopia/epidemiology ; Cross-Sectional Studies ; HIV ; Hepacivirus ; CD4 Lymphocyte Count

Nearly half of the deaths among hospitalized human immuno deficiency virus-infected patients in the highly active antiretroviral therapy era have been attributed to liver disease. This may range from an asymptomatic mild increase of liver enzymes to cirrhosis and liver failure. Different works of literature elucidated both retroviral infection and the adverse effects of highly active antiretroviral therapy as a cause of hepatotoxicity. Individual adaptations to medications and environmental exposures, shaped by cultural norms and genetic predispositions, could potentially modulate the risk and progression of liver disease in this population. Therefore, this study aims to assess the predictors of severe hepatotoxicity in retroviral-infected adults receiving highly active antiretroviral therapy regimens within the Ilubabor Zone, Southwest Ethiopia. A facility-based cross-sectional study was conducted among adult retroviral-infected patients in five selected anti-retro virus therapy clinics from May1 to July 30/2022. A systematic sampling technique was used to select 457 study participants and Binary logistic regression statistical data analysis was used, P value < 0.05 was considered statistically significant. The prevalence of severe hepatotoxicity was 21.44% in the study population. CD ⁺⁴ count < 200 cells/mm ³ (AOR = 2.19, 95% CI 1.04-5.22, P = 0.01), human immunodeficiency virus co-infection with tuberculosis (AOR = 2.82, 95% CI 1.01-8.29, P = 0.03) and human immuno deficiency virus co-infection with hepatitis-B/hepatitis C virus (AOR = 5.02, 95% CI 1.82-16.41) were predictors of severe hepatotoxicity. The magnitude of severe hepatotoxicity was high among adult retroviral-infected patients on highly active anti-retroviral drug regimens. Co-infection of human immuno deficiency virus with hepatitis B virus or hepatitis C virus, tuberculosis and CD4 ⁺ T-cell count below 200 cells/mm ³ were predictors of severe hepatotoxicity. Therefore, HIV patients on highly active antiretroviral therapy require close attention and regular monitoring of their liver function.
(© 2024. The Author(s).)

BMC Infect Dis. 2017 Feb 1;17(1):115. (PMID: 28148232)
PLoS One. 2022 Jul 1;17(7):e0270838. (PMID: 35776747)
BMJ Open. 2019 Apr 2;9(4):e023140. (PMID: 30944128)
Ann Hepatol. 2022 Jan;27 Suppl 1:100579. (PMID: 34793967)
BMC Res Notes. 2020 Jan 2;13(1):2. (PMID: 31898556)
HIV AIDS (Auckl). 2021 Jun 09;13:631-640. (PMID: 34135641)
World J Gastroenterol. 2014 Sep 21;20(35):12462-72. (PMID: 25253946)
HIV AIDS (Auckl). 2021 Feb 25;13:229-237. (PMID: 33664596)
Hepatol Med Policy. 2016 Aug 15;1:10. (PMID: 30288314)
Ethiop J Health Sci. 2013 Nov;23(3):217-26. (PMID: 24307821)
Sao Paulo Med J. 2007 Jul 5;125(4):205-9. (PMID: 17992389)
BMJ Open Gastroenterol. 2017 Oct 26;4(1):e000166. (PMID: 29119002)
BMC Gastroenterol. 2020 Apr 6;20(1):91. (PMID: 32252653)
BMC Gastroenterol. 2022 Jun 3;22(1):286. (PMID: 35658835)
HIV AIDS (Auckl). 2016 Dec 22;9:1-7. (PMID: 28053556)
JAMA. 2000 Jan 5;283(1):74-80. (PMID: 10632283)
AIDS. 2007 Aug 20;21(13):1701-10. (PMID: 17690567)
Clin Infect Dis. 2004 Mar 1;38 Suppl 2:S65-72. (PMID: 14986277)
PLoS One. 2015 Aug 06;10(8):e0134449. (PMID: 26247879)
Afr Health Sci. 2015 Jun;15(2):322-7. (PMID: 26124775)
PLoS One. 2014 Apr 08;9(4):e94271. (PMID: 24714066)
AIDS Res Treat. 2016;2016:1985452. (PMID: 27493798)
J Int Assoc Provid AIDS Care. 2019 Jan-Dec;18:2325958219884939. (PMID: 31665968)
East Afr Med J. 2013 Sep;90(9):276-87. (PMID: 26862645)
PLoS One. 2008 Mar 19;3(3):e1809. (PMID: 18350147)
Biomed Res Int. 2021 Jun 16;2021:6613519. (PMID: 34222476)
N Engl J Med. 2002 Mar 14;346(11):811-20. (PMID: 11893792)
Biomed Res Int. 2020 May 12;2020:9631731. (PMID: 32462039)
Clin Infect Dis. 2020 Jun 10;70(12):2675-2682. (PMID: 31622456)

Keywords: Anti-retroviral therapy; Co-infection; Enzymes; Liver

Date Created: 20240411 Date Completed: 20240415 Latest Revision: 20240425

20240425

PMC11009247

10.1038/s41598-024-57900-7

38605149