title: Period of onset and lack of clinical manifestation of hepatotoxicity after commencing highly active antiretroviral therapy.
abstract: OBJECTIVE
  The period of onset of hepatotoxicity varies between cohorts as do their clinical manifestations. Clinical manifestations of hepatotoxicity that have been previously reported include fatal portal hypertension, dress syndrome, and lipodystrophy syndrome. The aim of this study was to determine the period of onset and clinical manifestation of hepatotoxicity after commencing HAART.
  
  
  METHODS
  This study was carried out on patients with HIV on HAART attending infectious disease clinic, gastroenterology clinic or admitted into the medical wards of University of Benin Teaching Hospital. Patients with HIV but not on HAART were used as controls. A clinical evaluation and relevant laboratory investigations were done. Hepatotoxicity was defined using a standardized toxicity grade scale.
  
  
  RESULTS
  A total of 84 cases and 42 controls were studied. The mean ages were 35.2 ± 9.9 years and 35.5 ± 9.0 years for the cases and the controls respectively. Over 70% of the study population and controls were females. The overall incidence of hepatotoxicity was 17.85% and severe hepatotoxicity occurred in 10.71% of the patients. Over 80% of liver enzyme elevations occurred within 3 months, most of which were asymptomatic.
  
  
  CONCLUSIONS
  This study shows that over 80% of enzyme elevations occurred within 3 months and were mostly asymptomatic. There is a need for regular monitoring of liver function tests at short intervals in HIV patients starting HAART since most of the cases of hepatotoxicity found in this study occurred early and were asymptomatic.
authors.affiliation: Department of Medicine, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria. rosierosekes@yahoo.com
authors.forename: R A
authors.initials: RA
authors.lastname: Ugiagbe
authors.forename: E E
authors.initials: EE
authors.lastname: Ugiagbe
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects* / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D016022:Case-Control Studies; D056486:Chemical and Drug Induced Liver Injury; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy*; D006525:Hepatitis, Viral, Human / Q000150:complications*; D006784:Hospitals, Teaching; D006801:Humans; D015994:Incidence; D008099:Liver / Q000187:drug effects / Q000503:physiopathology; D008111:Liver Function Tests; D008297:Male; D009549:Nigeria / Q000453:epidemiology; D012307:Risk Factors; D013997:Time Factors
chemical_list: D019380:Anti-HIV Agents