Liver disease has emerged as the most common non-AIDS-related cause of

Liver disease has emerged as the most common non-AIDS-related cause of death in HIV patients. viral hepatitis. The prevalence of liver enzyme abnormality was 20.1% and 22.0% among HAART experienced and HAART na?ve patients respectively. The HAART experienced patients experienced higher mean ALT than HAART na?ve patients (= 0.002). Viral hepatitis (AOR = 6.02; 95% CI = 1.87-19.39) opportunistic infections (AOR = 2.91; 95% CI = 1.04-8.19) current CD4 count <200 cells/mm3 (AOR = 2.16; 95% CI = 1.06-4.39) and male sex (AOR = 1.83; 95% CI = 1.001-3.33) were associated with elevated ALT and/or AST. In conclusion liver enzyme abnormalities were high in both HAART experienced and HAART na?ve HIV-1 infected patients. Hence monitoring and management of LEFTY2 liver enzyme abnormalities in HIV-1 infected patients are important in our setting. 1 Introduction Liver disease has emerged as the most common non-AIDS-related cause of death among HIV infected patients accounting for 14-18% of all deaths [1 2 Nearly half of deaths among hospitalized HIV infected patients in the HAART era have been attributed to liver disease [3 4 It ranges from asymptomatic moderate elevations of liver enzymes to cirrhosis and end stage liver disease with all its complications (e.g. ascites esophageal varices and hepatic encephalopathy). Liver cirrhosis is a more severe result with an estimate overall prevalence of 8.3% in HIV infected persons [5]. Liver disease is usually often reflected by biochemical abnormalities of liver function. Many authors agree ABT-869 that elevated serum activity of the two commonly used liver enzymes (alanine aminotransferase ABT-869 [ALT] and aspartate aminotransferase [AST]) that are involved in breakdown of amino acids reflects liver cell injury [6-8]. Opportunistic infections AIDS related neoplasms [9 10 concomitant contamination with chronic hepatitis C computer virus (HCV) chronic hepatitis B computer virus (HBV) medication-related hepatotoxicity alcohol abuse and nonalcoholic fatty liver disease are some of the factors accounting for liver enzyme abnormalities in people infected with HIV [11-14]. However the risk factors and the burden of liver disease might be different in different geographical areas including our setting in Ethiopia. Managing liver disease is an important component of the care of HIV infected individuals. However there is limited study that evaluated the burden and causes of liver enzyme abnormality among HIV patients in the clinical settings in Ethiopia. The aim of this study was to (1) determine the prevalence of liver enzyme abnormalities and (2) identify factors associated with liver enzyme elevations among HIV-1 infected patients. 2 Material and Methods 2.1 Study Setting and Study Subjects This comparative cross-sectional study design was ABT-869 conducted to assess liver enzymes abnormalities in HIV-1 infected patients at Debre Tabor Hospital from February to April 2013. Debre Tabor Hospital provides health services to more than 2.3 million people for inpatients with 88 beds and outpatients. Antiretroviral therapy (ART) support for both HAART experienced and HAART na?ve HIV-1 patients has been given in the hospital since 2006. A total of 5453 HIV infected patients had followed their health end result at this hospital. HAART experienced patients with 1a (d4T+3TC+NVP) 1 (d4T+3TC+ EFV) 1 (AZT+3TC+ NVP) 1 (AZT+3TC+EFV) 1 (TDF+3TC+EFV) and 1f (TDF+3TC+NVP) regimen and HAART na?ve HIV infected patients were study subjects. In this study 164 HAART experienced and 164 HAART na?ve patients were included using 30% prevalence of liver enzyme abnormality among HIV infected patients in a similar setting [15] 95 confidence interval odds ratio of 2 and 80% power. Study subjects were selected consecutively in each group. Patients who experienced no sufficient blood specimen to determine liver enzymes ABT-869 (ALT and/or AST) level and history of taking some drugs other than HAART and prophylaxis were excluded from this study. 2.2 Operational Definitions ALT or AST enzyme level >1.25 times upper limit normal value (ULN). ALT or AST enzyme level >5.1-10X ULN (grade 3) and >10X ULN (grade 4) [16]. HIV-1 patients had taken ≥95% of the prescribed dosage regimen. 2.3 Data Collection Process and Quality Control Demographic and clinical data were collected using a structured questionnaire. From each participant 3 of venous blood specimen was collected in a plain vacutainer tube and centrifuged at 300?rpm for 10 minute to get sera for liver enzyme determination and viral hepatitis screening. In addition ABT-869 around 3?mL of venous blood.