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Effect of Antiretroviral Drugs on Liver Biochemical Parameters of HIV/AIDS-Infected Pregnant Women in Enugu Metropolis, Nigeria: A Cross-Sectional Study

[ Vol. 17 , Issue. 2 ]

Author(s):

Gordon I.E. Udalor, Chukwugozie N. Okwuosa, Ikenna K. Uchendu* and Chidozie E. Agu   Pages 156 - 167 ( 12 )

Abstract:


Background and Objective: Certain liver diseases are uniquely associated with pregnancy, whereas others are unrelated. Highly Active Antiretroviral Therapy (HAART)-associated hepatic toxicity is of increasing concern in the management of patients with HIV/AIDS. There is no available data on whether the pregnancy is associated with an increased risk of liver damage and chronic liver damage in HIV-positive women on HAART. We evaluated the effects of antiretroviral drugs on the liver biochemical parameters in HIV-infected pregnant women.

Methods: Using a cross-sectional survey design, 171 women were exclusively screened for hepatitis B and hepatitis C infections; grouped as 50 HIV seronegative pregnant women, 20 newly diagnosed HIV-infected pregnant women (treatment-naïve), 51 HIV-infected pregnant women already on HAART, 12 non-pregnant infected females (treatment-naive) and 38 non-pregnant HIV-infected women on HAART. Liver biomarkers were determined using standard methods. Student’s t-test and one-way analysis of variance (ANOVA) followed by Tukey’s Post-HOC multiple comparison tests were used to analyse the results.

Results: The Aspartate Transaminase (AST), Alanine Transaminase (ALT), Alkaline Phosphatase (ALP) and Total Bilirubin (TB) levels in HIV-infected pregnant women on HAART were elevated. The AST (29.40±4.35 U/L) of naïve HIV-infected pregnant women was significantly low (p<0.05) compared to non-pregnant naive HIV-infected women with AST (53.36±5.92 U/L). Also, the ALP (272.5±22.79 U/L) and TP (80.9±4.40 g/L) of naïve HIV-infected pregnant women were highly significant (p<0.05) compared to non-pregnant naive HIV-infected women with ALP and TP levels of (200.30±12.74 U/L) and (63.70±6.50) g/L respectively. On the basis of the trimester, HIVpositive pregnant women on HAART had significantly higher levels of liver markers when compared with that of HIVsero-negative pregnant women.

Interpretation and Conclusion: Pregnancy is associated with an increased risk of liver damage and chronic liver damage in HIV-positive women on HAART.

Keywords:

Antiretroviral drugs, HAART, liver biomarkers, HIV/AIDS, pregnant women, pregnancy, Nigeria.

Affiliation:

Department of Medical Laboratory Science, Faculty of Health Science and Technology, University of Nigeria, Enugu Campus, Enugu State, Department of Medical Laboratory Science, Faculty of Health Science and Technology, University of Nigeria, Enugu Campus, Enugu State, Department of Medical Laboratory Science, Faculty of Health Science and Technology, University of Nigeria, Enugu Campus, Enugu State, Prime Health Response Initiative (PHRI)-Global Fund HIV/AIDS Project, Ilorin, Kwara State



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