Biochemical evaluation of liver function enzymes in Lassa fever patients Évaluation biochimique des enzymes de la fonction hépatique chez les patients atteints de fièvre de Lassa

Abstract

Background: Lassa fever (LF) is a zoonotic acute viral hemorrhagic disease caused by the Lassa virus (LV). It has a high case fatality rate of about 5,000 deaths in humans from 300,000-500,000 cases each year globally. The high mortality rate from Lassa fever has been associated with abnormal liver enzyme production due to LV infiltration of the liver. However, data are sparse on the different enzymes and their proportions associated with LF. This study aims to evaluate the effect of LF on the levels of selected liver enzymes.
Methodology: This was a case-control epidemiological study of 100 participants comprising 70 participants with LF attending Federal Medical Centre, Owo between May and September 2023, and 30 healthy controls randomly selected within the hospital environs. Demographic information (age and gender) was collected from the participants with data collection form. Venous blood samples were collected from the participants into appropriate sample bottles and centrifuged to separate plasma for laboratory analyses. Lassa fever was confirmed by amplification of LV RNA using reverse transcriptase-polymerase chain reaction (RT-PCR) technique. Specific liver enzymes, including alanine transaminase (ALT), aspartate transaminase (AST), and alkaline phosphatase (ALP), were assayed from the plasma using Mindray chemistry system with Architect c8000 and Roche Cobas c501 chemistry analyzers. Data were analysed using SPSS version 20.0. software. Mean values were compared using the t-test while categorical variables were compared using the Chi-square test. Statistical significance was set at p<0.05 with 95% confidence interval.
Results: The results showed that among the study participants, the age group 20-39 years had the highest frequency of LF (37.1%, 26/70), with a slightly higher frequency in the females (51.4%, 36/70), compared to the males (48.6%, 34/70). The mean plasma ALP level of 263.84±50.73 U/L in LF patients was significantly higher than 46.80±1.85 U/L in the controls (t=35.740, p<0.0001). Similarly, the mean plasma ALT level of 158.96±11.46 U/L in LF patients was significantly higher than 10.67±8.55 U/L in the control (t=71.405,
p<0.0001), and the mean plasma AST level of 283.0±15.71 U/L in LF patients was significantly higher than 19.26±9.02 U/L in the control (t=105.60, p<0.0001). Elevated plasma levels of ALP, ALT and AST were recorded in 45.7%, 70.0% and 85.7% of LF patients, compared to 0%, 6.7% and 6.7% in the controls respectively (p<0.0001).
Conclusion: The study found significantly elevated liver enzymes in LF patients, providing insights into the pathological effects of the LV virus on the liver.