Evaluation of quantitative liver function tests in HIV-positive patients under anti-retroviral therapy.
OBJECTIVE
Quantitative tests of liver function (QTLF) which are based on the hepatic metabolism or clearance of test substances have been successfully used to predict prognosis of a variety of different liver diseases. Still sufficient data in HIV-patients under anti-retroviral therapy (ART) are lacking. Therefore, the aim of this prospective study was to investigate if and to what extent ART influences a broad panel of quantitative tests of liver function in patients with HIV-infection.


METHODS
Nineteen patients (14 males, 5 females, mean age 40 years) with HIV-infection underwent QTLF including lidocaine half-life test (LHT), galactose elimination capacity (GEC), and indocyanine green clearance (IGC). These tests were performed before and 3 to 6 months after initiation of anti-retroviral therapy. Twenty age-matched healthy, medication- and virus-free adults served as controls.


RESULTS
Lidocaine half-life was significantly lower in HIV-patients without ART. Combining anti-retroviral therapies shifted cytochrome p450 activity back into standard ranges. Galactose elimination capacity as a parameter of cytosolic liver function and indocyanine green clearance as a parameter of liver perfusion were not affected by ART.


CONCLUSIONS
QTLF may be a tool to predict prognosis or hepatic complications in HIV-infected patients with liver disease. Early determination of lidocaine half-life seems to be useful - this should be considered during the treatment of HIV-positive individuals.
Miller
M
M
Department of Gastroenterology and Hepatology, University Hospital Essen, Hufelandstr. 55, 45122 Essen, Germany.
Kahraman
A
A
Ross
B
B
Beste
M
M
Gerken
Guido
G
D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D005260:Female; D005690:Galactose / Q000008:administration & dosage / Q000493:pharmacokinetics; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy*; D006207:Half-Life; D006509:Hepatitis B / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D006526:Hepatitis C / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage / Q000493:pharmacokinetics; D008099:Liver / Q000378:metabolism / Q000503:physiopathology*; D008107:Liver Diseases / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D008111:Liver Function Tests / Q000379:methods*; D008297:Male; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D011379:Prognosis; D015203:Reproducibility of Results
D000998:Antiviral Agents; D008012:Lidocaine; D005690:Galactose