Aminotransferase Serum Levels Decrease after Initiating Antiretroviral Treatment in HIV Infected Patients

Jose      Antonio Mata-Marin; Jesus      Gaytan Martinez; Rafael      Arias Flores; Sergio      Mendoza Alvarez; Ivan      de Jesus Asencio Montiel

Abstract

Aim: To evaluate the effect of antiretroviral treatment on aminotransferase serum levels in treatment-naïve patients infected with human immunodeficiency virus (HIV).

Methods: We conducted a longitudinal study in treatment-naive patients infected with HIV. Patients were excluded if they had consumed alcohol during the last three months or had an opportunistic disease or co-infection. All 54 enrolled patients were evaluated and those having a CD4+ cell count < 350 cells/ml (41/54) were allocated to the treatment group (TG), while those with CD4+ counts > 350 cells/ml (13/54) did not receive any anti-retroviral treatment (ART). TG patients received either efavirenz (EFV) (21/41) or lopinavir/ritonavir (LPV/RTV) (20/41), each with zidovudine/lamivudine (ZDV/LMV).

Results: During the trial, 2 subjects in the EFV group were excluded due to rash and 1 subject in the LPV/RTV group due to gastric intolerance. The remaining 51 subjects (13 (25.5%) in the NTG and 38 (74.5%) in the TG) were included in the data analysis. Overall, 43 (84%) of analyzed patients were male and 8 (16%) female with an overall mean age of 33 ± 9 years. Of the 38 treated patients, 19 received LPV/RTV and 19 received EFV. Patients in the TG showed an increase in their CD4+ cell count, a decrease in aspartate aminotransferase (AST) from 39.3 ± 28 IU/ml to 22.7 ± 6 IU/ml (p = 0.02), and a decrease in alanine aminotransferase (ALT) from 52.0 ± 25 IU/ml to 23.8 ± 13 IU/ml (p < 0.01). Patients in the NTG showed no statistically significant differences in these measurements. Positive correlation was found between HIV viral load, AST (r = 0.31, p = 0.001) and ALT (r = 0.40, p = 0.04).

Conclusions: There is a significant decrease in aminotransferase serum levels following the initiation of antiretroviral treatment in HIV infected patients.

Keywords: AST, aminotransferase, antiretroviral therapy, ALT, hepatic injury, HIV, tissue, immunodeficiency, HIV-infected patients, hepatotropic, hepatotoxicity, steatosis, antiretrovial drugs, nevirapine, mitochondrial toxicity, serum levels, hepatitis, AIDS disease, polymerase chain reaction