Significance of liver enzymes as a baseline investigation in recently diagnosed HIV positive patients

Abstract

Background: Liver disease is a common feature in patients with Human Immunodeficiency Virus (HIV) infection and hence it is important to consider its involvement when treating HIV infected patients. In this study we analysed the liver functions by estimating the liver enzymes [Alanine amino transferases (ALT), Aspartate amino transferases (AST)] and bilirubin levels [total/unconjugated] at the time of diagnosis of HIV positive patients and compared it with healthy controls. This study aimed to determine the baseline values of liver enzymes and total and unconjugated bilirubin before the start of antiretroviral therapy. Methods : Liver enzymes [ALT and AST] and Bilirubin [total and unconjugated bilirubin] were analysed in a total of 200 patients and compared with equal number of age and sex matched healthy controls. Results: The mean age of healthy controls were 37.179.12 years and the mean age of the HIV positive cases were 43.1411.09 years In recently positive HIV patients the increase in liver enzymes [ALT and AST] and Bilirubin [total, unconjugated] was statistically significant ( P 0.001) when compared to the healthy controls Conclusion: The involvement of liver as reflected by increase in enzymes and bilirubin at the time of diagnosis is significant as there is a time lag between the onset of infection to that of diagnosis. Therefore the baseline liver function tests at the time of diagnosis, before the start of antiretroviral therapy acts as a prognostic indicator and is useful in subsequent monitoring of the patient.