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Liver Function Markers and Associated Serum Electrolytes Changes in HIV Patients Attending Patient Support Centre of Jaramogi Oginga Odinga Teaching and Referral Hospital, Kisumu County, Kenya
Abstract
Objective: To determine the distribution of markers of liver function disorders and their association with co-existing fluids and electrolytes states in ambulatory HIV infected individuals.
Design: A case-control study.
Setting: Jaramogi Oginga Odinga Teaching and Referral Hospital’s Patient Support Centre.
Intervention: Biochemical analysis were performed for serum alanine-aminotranferase (ALT), aspartate-amino transferase (AST), total protein, albumin, glucose, urea, potassium, sodium, chloride, creatinine phosphate, total and direct bilirubin levels as well as CD4 lymphocyte levels.
Results: Serum liver function markers were significantly altered in HIV infected individuals compared to uninfected individuals (mean serum aspartate-amino transferase (AST); 45.1U/l v/s 36.9U/l; alanine-aminotransferase (ALT), 36.5U/l v/s 30.7U/l; direct bilirubin, 4.9ìmol/l v/s 4.2ìmol/l; total bilirubin, 6.2ìmol/l v/s 5ìmol/l; albumin32.8g/l v/s 34.5g/l and protein 64g/l v/s 67.1g/l; p <0.0001). The prevalence of pathological levels of serum liver function markers was also higher in HIV-infected
patients than HIV-negative participants (ALT, 4.4% v/s 0.7%, p=0.001; AST, 24.5% v/s 6.7%, p<0.0001; direct bilirubin, 43.1% v/s 36.5%, p=0.026; total bilirubin, 2.3% v/s 0%, p=0.002; serum albumin, 60.1% v/s 52.2%, p= 0.009 and serum total protein levels, 52.8% v/s 36%, p<0.0001). Gender, age and anti-retroviral treatment were not predictors of
aberrations in levels of liver function markers in HIV infected patients. Marked CD4 depletion was associated with enhanced deterioration of liver function markers. Liver function anomalies did not conduce co-existing electrolyte anomalies as clinically altered ALT states only correlated and co-varied with AST states (r = 0.917) ; direct biliribun states co-varied with total bilirubin levels (r = 0.958) and serum album states correlated with protein levels (r = 0.917) and vice versa.
Conclusion: Liver function disorders are not infrequent in HIV infected individuals and routine review of liver health status is essential in comprehensive care of HIV patients.
Design: A case-control study.
Setting: Jaramogi Oginga Odinga Teaching and Referral Hospital’s Patient Support Centre.
Intervention: Biochemical analysis were performed for serum alanine-aminotranferase (ALT), aspartate-amino transferase (AST), total protein, albumin, glucose, urea, potassium, sodium, chloride, creatinine phosphate, total and direct bilirubin levels as well as CD4 lymphocyte levels.
Results: Serum liver function markers were significantly altered in HIV infected individuals compared to uninfected individuals (mean serum aspartate-amino transferase (AST); 45.1U/l v/s 36.9U/l; alanine-aminotransferase (ALT), 36.5U/l v/s 30.7U/l; direct bilirubin, 4.9ìmol/l v/s 4.2ìmol/l; total bilirubin, 6.2ìmol/l v/s 5ìmol/l; albumin32.8g/l v/s 34.5g/l and protein 64g/l v/s 67.1g/l; p <0.0001). The prevalence of pathological levels of serum liver function markers was also higher in HIV-infected
patients than HIV-negative participants (ALT, 4.4% v/s 0.7%, p=0.001; AST, 24.5% v/s 6.7%, p<0.0001; direct bilirubin, 43.1% v/s 36.5%, p=0.026; total bilirubin, 2.3% v/s 0%, p=0.002; serum albumin, 60.1% v/s 52.2%, p= 0.009 and serum total protein levels, 52.8% v/s 36%, p<0.0001). Gender, age and anti-retroviral treatment were not predictors of
aberrations in levels of liver function markers in HIV infected patients. Marked CD4 depletion was associated with enhanced deterioration of liver function markers. Liver function anomalies did not conduce co-existing electrolyte anomalies as clinically altered ALT states only correlated and co-varied with AST states (r = 0.917) ; direct biliribun states co-varied with total bilirubin levels (r = 0.958) and serum album states correlated with protein levels (r = 0.917) and vice versa.
Conclusion: Liver function disorders are not infrequent in HIV infected individuals and routine review of liver health status is essential in comprehensive care of HIV patients.
