title: A cross-sectional study of liver function tests in HIV-infected persons in Western India.
abstract: BACKGROUND
  Derangement of liver function tests (LFTs) is common in people living with human immunodeficiency virus/acquired immune deficiency syndrome (PLHA). The cause is multifactorial. Drug-induced liver injury (DILI) is the commonest cause and others being alcohol abuse and concomitant viral hepatitis. The aim of the research was to study the prevalence of LFT abnormalities in PLHA.
  
  
  METHODS
  The study was carried out in a tertiary care hospital. Evaluation included a detailed history, thorough clinical examination and investigations including a haemogram, serum biochemistry, serology for hepatitis, and CD4 cell count.
  
  
  RESULTS
  A total of 247 patients were evaluated. Of these, 212 (85.82%) were on antiretroviral therapy (ART), 111 (44.93%) were on anti-tubercular therapy (ATT), and 94 (38.05%) were on concurrent ATT-ART. Abnormal LFTs were seen in 128/247 (51.82%) PLHA. In the majority (88.28%), the LFT abnormalities were mild. LFT abnormalities were seen in 109/212 (51.4%) patients on ART, in 56/111 (50.5%) patients on ATT, 46/94 (48.93%) patients on concurrent ART-ATT. There was no difference in LFT abnormalities among the three groups nor was there any significant association with alcohol consumption. There was a statistically significant co-relation between albumin/globulin ratio and CD4 count (p= 0.0002). Counter-intuitively, LFT abnormalities were commoner in patients not receiving nevirapine (p= 0.043), but severe abnormalities (grade III/grade IV) were commoner in those receiving nevirapine (p= 0.005) and in those on concurrent ART-ATT (p= 0.008).
  
  
  CONCLUSIONS
  LFT abnormalities in PLHA are common; but usually mild. There is a strong association between severe abnormalities and nevirapine-based therapy (p= 0.02) and concurrent ATT-ART (p= 0.008).
authors.affiliation: Resident, Department of Medicine, Armed Forces Medical College, Pune 411040, India.
authors.forename: Sunny
authors.initials: S
authors.lastname: Pathania
authors.affiliation: Assistant Professor (Medicine), Command Hospital (Southern Command), Pune 411040, India.
authors.forename: Navjyot
authors.initials: N
authors.lastname: Kaur
authors.affiliation: Assistant Professor, Department of Medicine, Armed Forces Medical College, Pune 411040, India.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Kumar
authors.affiliation: Professor & Head, Department of Geriatric Medicine, Armed Forces Medical College, Pune 411040, India.
authors.forename: V K
authors.initials: VK
authors.lastname: Sashindran
authors.affiliation: Professor & Head, Department of Internal Medicine, Armed Forces Medical College, Pune 411040, India.
authors.forename: Pankaj
authors.initials: P
authors.lastname: Puri
keywords: ART; ATT; LFT abnormality; PLHA; Prevalence