Risk Factors for Alanine Aminotransferase Elevations in a Prospective Cohort of HIV-Infected Tanzanian Adults Initiating Antiretroviral Therapy
Introduction: Serum alanine aminotransferase (ALT) elevations are common among HIV-infected patients on combination antiretroviral therapy (cART). Approach: We conducted a prospective cohort study of 3023 HIV-infected Tanzanian adults initiating cART. We assessed risk factors for mild/moderate ALT e...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2019-10-01
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| Series: | Journal of the International Association of Providers of AIDS Care |
| Online Access: | https://doi.org/10.1177/2325958219884939 |
| _version_ | 1818189102835564544 |
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| author | Sabina F. Mugusi MBBS, PhD David Sando MD, MPH, PhD Ferdinand M. Mugusi MD, MMed Claudia Hawkins MD, MPH Said Aboud MD, MMed, PhD Wafaie W. Fawzi MBBS, MPH, MS, DrPH Christopher R. Sudfeld ScM, ScD |
| author_facet | Sabina F. Mugusi MBBS, PhD David Sando MD, MPH, PhD Ferdinand M. Mugusi MD, MMed Claudia Hawkins MD, MPH Said Aboud MD, MMed, PhD Wafaie W. Fawzi MBBS, MPH, MS, DrPH Christopher R. Sudfeld ScM, ScD |
| author_sort | Sabina F. Mugusi MBBS, PhD |
| collection | DOAJ |
| description | Introduction: Serum alanine aminotransferase (ALT) elevations are common among HIV-infected patients on combination antiretroviral therapy (cART). Approach: We conducted a prospective cohort study of 3023 HIV-infected Tanzanian adults initiating cART. We assessed risk factors for mild/moderate ALT elevations >40 IU/L and severe ALT elevations >200 IU/L. Results: We found that over a median follow-up of 32.5 months (interquartile range: 19.4-41.5), 44.8% of participants had at least 1 incident ALT elevation >40 IU/L of which 50.1% were persistent elevations. Risk factors for incident ALT elevation >40 IU/L included male sex, CD4 count <100 cells/μL, d4T+3TC+NVP cART, and triglycerides ≥150 mg/dL ( P values <.05). Hepatitis B coinfection and alcohol consumption increased the risk of severe ALT elevations >200 IU/L ( P values: <.05). Conclusion: Incident mild and moderate ALT elevations are common among Tanzanians initiating cART, and the clinical and demographic information can identify patients at increased risk. |
| first_indexed | 2024-12-11T23:37:29Z |
| format | Article |
| id | doaj.art-0a3db380c0164850a23ebb571fafcfce |
| institution | Directory Open Access Journal |
| issn | 2325-9582 |
| language | English |
| last_indexed | 2024-12-11T23:37:29Z |
| publishDate | 2019-10-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of the International Association of Providers of AIDS Care |
| spelling | doaj.art-0a3db380c0164850a23ebb571fafcfce2022-12-22T00:45:49ZengSAGE PublishingJournal of the International Association of Providers of AIDS Care2325-95822019-10-011810.1177/2325958219884939Risk Factors for Alanine Aminotransferase Elevations in a Prospective Cohort of HIV-Infected Tanzanian Adults Initiating Antiretroviral TherapySabina F. Mugusi MBBS, PhD0David Sando MD, MPH, PhD1Ferdinand M. Mugusi MD, MMed2Claudia Hawkins MD, MPH3Said Aboud MD, MMed, PhD4Wafaie W. Fawzi MBBS, MPH, MS, DrPH5Christopher R. Sudfeld ScM, ScD6 Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA Department of Internal Medicine, School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania Center for Global Health, Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL, USA Department of Microbiology and Immunology, School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USAIntroduction: Serum alanine aminotransferase (ALT) elevations are common among HIV-infected patients on combination antiretroviral therapy (cART). Approach: We conducted a prospective cohort study of 3023 HIV-infected Tanzanian adults initiating cART. We assessed risk factors for mild/moderate ALT elevations >40 IU/L and severe ALT elevations >200 IU/L. Results: We found that over a median follow-up of 32.5 months (interquartile range: 19.4-41.5), 44.8% of participants had at least 1 incident ALT elevation >40 IU/L of which 50.1% were persistent elevations. Risk factors for incident ALT elevation >40 IU/L included male sex, CD4 count <100 cells/μL, d4T+3TC+NVP cART, and triglycerides ≥150 mg/dL ( P values <.05). Hepatitis B coinfection and alcohol consumption increased the risk of severe ALT elevations >200 IU/L ( P values: <.05). Conclusion: Incident mild and moderate ALT elevations are common among Tanzanians initiating cART, and the clinical and demographic information can identify patients at increased risk.https://doi.org/10.1177/2325958219884939 |
| spellingShingle | Sabina F. Mugusi MBBS, PhD David Sando MD, MPH, PhD Ferdinand M. Mugusi MD, MMed Claudia Hawkins MD, MPH Said Aboud MD, MMed, PhD Wafaie W. Fawzi MBBS, MPH, MS, DrPH Christopher R. Sudfeld ScM, ScD Risk Factors for Alanine Aminotransferase Elevations in a Prospective Cohort of HIV-Infected Tanzanian Adults Initiating Antiretroviral Therapy Journal of the International Association of Providers of AIDS Care |
| title | Risk Factors for Alanine Aminotransferase Elevations in a Prospective Cohort of HIV-Infected Tanzanian Adults Initiating Antiretroviral Therapy |
| title_full | Risk Factors for Alanine Aminotransferase Elevations in a Prospective Cohort of HIV-Infected Tanzanian Adults Initiating Antiretroviral Therapy |
| title_fullStr | Risk Factors for Alanine Aminotransferase Elevations in a Prospective Cohort of HIV-Infected Tanzanian Adults Initiating Antiretroviral Therapy |
| title_full_unstemmed | Risk Factors for Alanine Aminotransferase Elevations in a Prospective Cohort of HIV-Infected Tanzanian Adults Initiating Antiretroviral Therapy |
| title_short | Risk Factors for Alanine Aminotransferase Elevations in a Prospective Cohort of HIV-Infected Tanzanian Adults Initiating Antiretroviral Therapy |
| title_sort | risk factors for alanine aminotransferase elevations in a prospective cohort of hiv infected tanzanian adults initiating antiretroviral therapy |
| url | https://doi.org/10.1177/2325958219884939 |
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