Antiretroviral Therpay Induced Liver Toxicity among Immunecompromised HIV Patients at Chu Brazzaville
- 1 Faculty of Health Sciences, Marien Ngouabi University, Brazzaville, Congo
- 2 Gastroenterolgy service University Hospital of Brazzaville, Brazzaville, Congo
- 3 Faculty of Health Sciences, Marien Ngouabi University, Brazzaville, Congo
- 4 Faculty of Health Sciences, Marien Ngouabi University, Brazzaville, Congo
- 5 Infant pediatric service University Hospital of Brazzaville, Brazzaville, Congo
- 6 Gastroenterolgy service University Hospital of Brazzaville, Brazzaville, Congo
- 7 Gastroenterolgy service University Hospital of Brazzaville, Brazzaville, Congo
- 8 Gastroenterolgy service University Hospital of Brazzaville, Brazzaville, Congo
- 9 Faculty of Health Sciences, Marien Ngouabi University, Brazzaville, Congo
- 10 Gastroenterolgy service University Hospital of Brazzaville, Brazzaville, Congo
- 11 Gastroenterolgy service University Hospital of Brazzaville, Brazzaville, Congo
- 12 Medical Depertment, University Teaching Hospital, Kigali, Rwanda
- 13 Faculty of Health Sciences, Marien Ngouabi University, Brazzaville, Congo
- 14 Gastroenterolgy service University Hospital of Brazzaville, Brazzaville, Congo
- 15 College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
Abstract
Introduction: Human immunodeficiency virus (HIV) infection is a public health problem of concern. Anti-retroviral therapy (ART) is associated with multiple side effects. This study aimed at identifying the different hepatic manifestations of antiretroviral therapy and the responsible molecules. Patients and Methods: This was an eight months period prospective descriptive study, from January 1st to August 31st, 2015, conducted in the Department of Gastroenterology and Internal Medicine at the Brazzaville University Teaching Hospital. Study participants were treatment-naïve HIV patients who were initiated on ART treatment during the study period. Patients with liver disease, liver cytolysis prior to initiation of therapy, and those with alternative therapy that may cause hepatotoxicity were excluded. The sample size was 110 patients. Results: The age was ranging from 25 to 70 years with a mean age of 47.5 ± 7.5 years. During the six months of follow-up, the alarming hepatic signs were observed in 26.36% of cases (n = 29) in the 3rd month of treatment. There was no observed alarming sign in the 6th month of follow-up. The cytolytic pattern was observed in 54.55% of cases (n = 60) in the 3rd month. The cholestatic pattern was observed in 6.36% of cases (n = 7) in the 3rd month. Triple therapy combination of Zidovudine, Lamivudine and Nevirapine (AZT + 3TC + NVP) was the most used in 57.27% (n = 63) with a statistically significant p value to the occurrence of cytolytic pattern (p < 0.03) in the 3rd month of treatment. Conclusion: Drug induced liver toxicity occurs in a significant number of patients starting ART. The prevalence of hepatic events was high at the third month of treatment and the triple therapy of Zidovudine, Lamivudine and Nevirapine (AZT + 3TC + NVP) was the most incriminated.
- Rosenbach, K., Allison, R. and Nadler, J. (2002) Daily Dosing of Highly Active Antiretroviral Therapy. Clinical Infectious Diseases, 34, 686-692. https://doi.org/10.1086/338255
- Taburet, A.-M., Paci-Bonaventure, S., Peytavin, G. and Molina, J.-M. (2003) Once-Daily Administration of Antiretroviral. Pharmacokinetic of Emerging Therapies. Clinical Pharmacokinetics, 42, 1179-1191. https://doi.org/10.2165/00003088-200342140-00001
- Sterling, R.K., Chiu, S., Suider, K. and Nixon, D. (2008) The Prevalence and Risk Factors for Abnormal Liver Enzymes in HIV-Positive Patient without Hepatitis B or C Coinfections. Digestive Diseases and Sciences, 53, 1375-1382. https://doi.org/10.1007/s10620-007-9999-6
- Lohse, N., Hansen, A.B., Pedersen, G., Kronborg, G., Gerstoft, J., Sorensen, H.T., et al. (2007) Survival of Persons with and without HIV Infection in Denmark, 1995-2005. Annals of Internal Medicine, 146, 87-95. https://doi.org/10.7326/0003-4819-146-2-200701160-00003
- Sawadogo, A.B., Drabo, J., Meda, N., Compaore, G., et al. (2007) Etude prospective d’une cohorte de patients infectés par le VIH traits par les antirétroviraux: comparaison de dispositifs de prise en charge centralisé et décentralisé au Burkina Faso. Médecine Sciences, 23, 88.
- Zannou, D., Houngbé, F., Acapko, J., Adé, G., Gougounou, A. and Akondé, A. (2007) Undesirable Effect of Antiretroviral Drugs in Patients Infected with HIV at Cotonou Benin. Le Mali Medical, 22, 37-43.
- Centre National de la Statistique et des Études Économiques (2009) CNSEE Enquête de Séroprévalence et sur les Indicateurs du Sida au Congo (ESISC-I) 2009. http://www.cnsee.org/pdf/RapSyntESISC.pdf
- Frater, A.J., Dunn, D.T., Beardall, A.J., Ariyoshi, K., Clarke, J.R., McClure, M.O. and Weber, J.N. (2002) Comparative Response of African HIV-1-Infected Individuals to Highly Active Antiretroviral Therapy. AIDS, 16, 1139-1146. https://doi.org/10.1097/00002030-200205240-00007
- Neuman, M.G., Schneider, M., Nanau, R.M. and Parry, C. (2012) HIV-Antiretroviral Therapy Induced Liver, Gastrointestinal, and Pancreatic Injury. International Journal of Hepatology, 2012, Article ID: 760706.
- Sungkanuparph, S. and Mootsikapun, P. (2001) Efavirenz-Based Regimen in Advanced AIDS with Cryptococcal Meningitis: A Prospective Multicenter Study. 14th International AIDS Conference, Barcelone, December 2001, 64.