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摘要
We determined the associations of HIV infection/CD4 count with markers of hepatocellular damage [elevated aspartate aminotransferase (AST) and alanine aminotransferase (ALT)] and liver synthetic decreased albumin) in HIV-infected (HIV+) antiretroviral therapy (ART)-naive and uninfected (HIV-) Rwandan women. In 2005, 710 HIV+ ART-naive and 226 HIV- women enrolled in the Rwanda Women's Interassociation Study and Assessment. Liver enzymes were measured with abnormality defined as either AST or ALT >= 1.25 times the upper limit of normal. Low serum albumin level was defined as <3.5 g/dl. Multivariable logistic regression analysis identified independent predictors of elevated AST/ALT and low serum albumin. HIV- women had the lowest prevalence (6.6%) of abnormal AST/ALT, with the highest prevalence (16.4%) in HIV+ women with CD4 <200 cells/mu l (p = 0.01). The odds of having serum albumin <3.5 g/dl was 5.7-fold higher in HIV+ than HIV- women (OR = 5.68, 95% CI: 3.32-9.71). The risk of low albumin decreased from low to high CD4 count, with OR = 2.62, 95% CI: 1.66, 4.14 and OR = 1.57, 95% CI: 1.01, 2.43 in HIV+ women with a CD4 count <200 and 200-350 cells/mu l, respectively vs. HIV+ with CD4 > 350 (p < 0.001 and p < 0.05 for all comparisons). Our findings suggest that HIV-associated liver damage may occur in ART-naive patients. Although liver abnormality prevalences in this cohort of HIV(-)infected Rwandan women are less than reported in developed countries, caution is needed for risk assessment measures to monitor and screen HIV-infected patients pre- and post-ART initiation in African clinical settings to curtail potential risks associated with HIV infection.
- 出版日期2015-7
- 单位rutgers
