Impact of Highly Active Antiretroviral Therapy on Hepatic Enzyme Elevation among HIV Seropositive Individuals: A Case Control Study in Ghana

Background: Increasing access to highly active antiretroviral therapy (HAART) in our population in recent times has necessitated the assessment of the impact of these therapies on hepatic enzymes. We therefore aimed to assess the impact of highly active antiretroviral therapy on hepatic enzymes and to ascertain the trend of hepatic enzyme elevation in HIV disease progression.

Method: 192 confirmed HIV individuals consisting of 104 HAART experienced and 88 HAART naïve patients were recruited into the study. Venous blood was taken for the assay of Alkaline Phosphatase (ALP), Alanine aminotransferase (ALT), Aspartate aminotransferase (AST) and Gammaglutamyltransferase (GGT).

Results: There was a significant increase (p<0.0.5) in the median AST, GGT, ALT and ALP in the HAART naïve patients than the HAART experienced patients. There was a significant increase (p<0.0001) in the prevalence of AST, ALT, ALP and GGT elevation in the HAART naïve patients (35.2%, 28.4%, 28.4% and 48.9% respectively) than the HAART experienced patients (5.8%, 1.9%, 5.8% and 10.6% respectively).

Conclusion: It is clear from this study that HAART may have a minimal effect on hepatic enzyme elevation and longer duration of treatment does not result in liver enzyme elevation. Close monitoring of patients receiving HAART is still relevant.