title: Hepatic Enzyme Alterations in HIV Patients on Antiretroviral Therapy: A Case-Control Study in a Hospital Setting in Ghana.
abstract: BACKGROUND
  Diagnosing hepatic injury in HIV infection can be a herculean task for clinicians as several factors may be involved. In this study, we sought to determine the effects of antiretroviral therapy (ART) and disease progression on hepatic enzymes in HIV patients.
  
  
  METHODS
  A case-control study conducted from January to May 2014 at the Akwatia Government Hospital, Eastern region, Ghana, The study included 209 HIV patients on ART (designated HIV-ART) and 132 ART-naive HIV patients (designated HIV-Controls). Data gathered included demography, clinical history and results of blood tests for hepatic enzymes. We employed the Fisher's, Chi-square, unpaired t-test and Pearson's correlation in analysis, using GraphPad Prism and SPSS. A P value < 0.05 was considered significant.
  
  
  RESULTS
  Median CD4 lymphocyte count of HIV-ART participants (604.00 cells/mm3) was higher than that of HIV-Controls (491.50 cells/mm3; P = 0.0005). Mean values of ALP, ALT, AST and GGT did not differ between the two groups compared (P > 0.05). There was a significant positive correlation between hepatic enzymes (ALP, ALT, AST and GGT) for both groups (p < 0.01 each). Duration of ART correlated positively with ALT (p < 0.05). The effect size of disease progression on hepatic enzymes for both groups was small.
  
  
  CONCLUSIONS
  Antiretroviral therapy amongst this population has minimal effects on hepatic enzymes and does not suggest modifications in therapy. Hepatic injury may occur in HIV, even in the absence of ART and other traditional factors. Monitoring of hepatic enzymes is still important in HIV patients.
authors.affiliation: Department of Molecular Medicine, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
authors.forename: Derick Nii Mensah
authors.initials: DN
authors.lastname: Osakunor
authors.affiliation: Department of Molecular Medicine, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
authors.forename: Christian
authors.initials: C
authors.lastname: Obirikorang
authors.affiliation: Department of Medical Laboratory Technology, Faculty of Allied Health Sciences, Kwame Nkrumah University of Sciences and Technology, Kumasi, Ghana.
authors.forename: Vincent
authors.initials: V
authors.lastname: Fianu
authors.affiliation: Medical Laboratory Department, St. Dominic Catholic Hospital, Akwatia, Ghana.
authors.forename: Isaac
authors.initials: I
authors.lastname: Asare
authors.affiliation: Medical Laboratory Department, St. Dominic Catholic Hospital, Akwatia, Ghana.
authors.forename: Mavis
authors.initials: M
authors.lastname: Dakorah
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000032:analysis; D000469:Alkaline Phosphatase / Q000032:analysis; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D001219:Aspartate Aminotransferases / Q000032:analysis; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000166:cytology; D016022:Case-Control Studies; D018450:Disease Progression; D005260:Female; D005869:Ghana; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D008099:Liver / Q000201:enzymology*; D008297:Male; D008875:Middle Aged; D055815:Young Adult; D005723:gamma-Glutamyltransferase / Q000032:analysis
chemical_list: D019380:Anti-HIV Agents; D005723:gamma-Glutamyltransferase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D000469:Alkaline Phosphatase