Risk Factors of Severe Hepatotoxicity among HIV-1 Infected Individuals Initiated on Highly Active Antiretroviral Therapy in the Northwest Region of Cameroon
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Date
2022
Authors
Abongwa, Lem Edith
Nyamache, Anthony Kebira
Fokunang, Charles
Torimiro, Judith
Emmanuel, Nshom
Domkam, Irénée
Eyongetah, Mbu
Jude, Beriyuy
Mua, Fung Holgar
Bella, Sama
Journal Title
Journal ISSN
Volume Title
Publisher
BMC Gastroenterology
Abstract
Background: Hepatotoxicity due to highly active antiretroviral therapy (HAART) has gained prominent attention
since it can be afected by many factors. The aim of this study was to determine the prevalence of hepatotoxicity and
related risk factors of severe hepatotoxicity following HAART initiation.
Methods: A total of 100 drug-naive patients aged between 18 and 61 years were recruited. They were put on Tenofovir/Lamivudine/Efavirenz [TDF/3TC/EFV] (64), Zidovudine/ Lamivudine/Efavirenz [AZT/3TC/EFV] (22), and Zidovudine/
Lamivudine/Nevirapine AZT/3TC/NVP (14) and monitored for 6months and blood samples drawn.Alanine aminotransferases (ALT), aspartate aminotransferases (AST), and alkaline phosphatase (ALP) wereanalyzed by enzymatic methods
and used to classify levels of hepatotoxicity.
Results: A total of 37(37%) and 49(49%) patients presented with hepatotoxicity while 15% and 28% had severe
hepatotoxicity at 4 and 24 weeks respectively. Serum levels of all enzymes increased signifcantly (p=0.001) with
increased treatment duration. Univariate analysis revealed that the risk factor of developing severe hepatotoxicity was
signifcantly greater in patients<30years (p=0.02), males(p=0.04), low BMI (p=0.02), low monthly income (p=0.01)
earners, and patients on AZT+3TC+NVP regimen (p=0.01). While multivariate analysis at p<0.09 showed that age
30–40 years, low BMI, low monthly income, and the use of AZT+3TC+NVP regimen were independent risk factors.
Conclusions: Low BMI, age group of 30–40years, low monthly income, and the use of AZT+3TC+NVP regimen
identifed as risk factors for the development of severe hepatotoxicity should be considered as an important strategy
by clinicians in preventing the hepatotoxicity.
Description
Article
Keywords
Risk factors, Liver enzymes, HAART, HIV-1, Hepatotoxicity
Citation
Abongwa, L. E., Nyamache, A. K., Charles, F., Torimiro, J., Emmanuel, N., Domkam, I., ... & Okemo, P. (2022). Risk factors of severe hepatotoxicity among HIV-1 infected individuals initiated on highly active antiretroviral therapy in the Northwest Region of Cameroon. BMC gastroenterology, 22(1), 1-8.