title: Livolin ameliorates elevations in alanine transaminase in HIV infected patients commencing highly active antiretroviral therapy.
abstract: BACKGROUND
  HAART associated hepatoxicity is an important cause of poor adherence to therapy in HIV infected persons. An initial manifestation is elevation in the level ofAlanine Transaminase (ALT) in blood. We sought to evaluate the protective effects of Livolin, a phosphatidylcholine containing preparation, against elevations in this enzyme in persons just commencing HAART.
  
  
  METHODS
  All consenting patients deemed eligible for HAART and who were sero-negative for Hepatitis B and C were recruited into the study. Subjects were divided into a test group which received a thrice daily dose of Livolin capsules for 3 months in addition to HAART and a control group that received only HAART. Blood samples were collected at baseline and after 3 months and analysed for ALT, Aspartate aminotransferase, alkaline phosphatase and creatinine. The specific HAART combination, age and gender were also noted.
  
  
  RESULTS
  Seventy nine (79) persons comprised of 43 test and 36 control subjects completed the study. Sixty six percent (79%) of all subjects were on Nevirapine containing combinations. In total, 8.9% and 11.7% of our patients had elevations at baseline and after 3 months respectively. These were mostly grade I, with grade II toxicity being observed in 3.3% of patients after 3 months of HAART. There was no instance of severe toxicity. For individuals with an elevation in ALT values at baseline, the mean drop at 3 months was significantly more in the test group compared with the control group (34.67 iu/L vs. 14.90 iu/L, p=0.005). Among subjects with on Nevirapine, the mean increment in ALT in the control group was 7.73 iu/L compared with 1.73 iu/L for the test group.
  
  
  CONCLUSIONS
  The findings in this study mirror findings in both animal experiments and human studies of a potential benefit of phosphatidylcholine preparations, like Livolin, in protecting against drug induced hepatotoxicity.
authors.affiliation: Department of Medicine, University College Hospital, Ibadan, Nigeria.
authors.forename: J A
authors.initials: JA
authors.lastname: Otegbayo
authors.forename: M A
authors.initials: MA
authors.lastname: Kuti
authors.forename: O
authors.initials: O
authors.lastname: Ogunbode
authors.forename: A E
authors.initials: AE
authors.lastname: Irabor
authors.forename: I F
authors.initials: IF
authors.lastname: Adewoles
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood / Q000187:drug effects*; D000469:Alkaline Phosphatase / Q000097:blood / Q000187:drug effects; D019380:Anti-HIV Agents / Q000009:adverse effects*; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D001219:Aspartate Aminotransferases / Q000097:blood / Q000187:drug effects; D056486:Chemical and Drug Induced Liver Injury / Q000517:prevention & control*; D004338:Drug Combinations; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019829:Nevirapine / Q000009:adverse effects; D010713:Phosphatidylcholines / Q000627:therapeutic use*; D016896:Treatment Outcome; D014803:Vitamin B Complex / Q000627:therapeutic use; D014810:Vitamin E / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents; D004338:Drug Combinations; D010713:Phosphatidylcholines; D014803:Vitamin B Complex; D014810:Vitamin E; D019829:Nevirapine; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D000469:Alkaline Phosphatase