High Prevalence of Hepatotoxicity on HIV Patients under TDF First Base

In this cross-sectional study, our data demonstrate a high prevalence of hepatotoxicity 21.65% (225). Among 1039 HIV infected individuals, 8.2% (85) were on NVP based regimen, 38.8% (403) were on EFV based regimen, 26.18% (272) were on PI based regimen and 9.8% (102) were on raltegravir based regimen; of which only 2.4% experienced severe hepatotoxicity (n=25). This is in contrast with the previous findings, as many previous studies conducted so far have reported high prevalence of severe hepatotoxicity. For example a study conducted by Ferdinand et al., reported grade 4 hepatotoxicity in 7.9% patients [8], a retrospective study conducted at Duke University Medical Center (DUMC) and Durham VA Medical Center (DVAMC) Infectious Diseases Clinics have reported 10.7% incidence of severe hepatotoxicity [9]. However, a recent study conducted on Ethiopian cohort have reported grade 3 and grade 4 hepatotoxicity among 1.84% of HIV infected patients [10]. The reason why the higher incidence was found among other cohort studies might be our study excluded patient with HBV/HCV infection. Among the 225 patients, 12.31% of them were on first line ART regimen. However SH among patient on first line ART was found to be present in 1.82%, this is similar with the previous finding that, among those receiving first line ART 1.7% had SH. However many finding states that overall rate of SH was between (4.2% - 8.9%) [11-13].In addition by analyzing further we found that SH was found to be higher in NVP (19.35%) than EFV (14.4%) based NNRTI, this is in line with the previous findings. The proportion of hepatotoxicity among HIV infected individuals is found to be 3.84%, 2.21%, 0.96% for patients who are ART naà ¯ve, on PI based regimen and raltegravir based ... ...transformed for statistical analysis. CD4 T-cell measurement was performed using flowcytometer FC 500, (Beckman Coulter, Pasadena, CA, USA), ALT and AST level were measured in Olympus AU400 Chemistry analyzer (Beckman Coulter, Pasadena, CA, USA). Statistical analysis: Baseline characters were recorded as median and interquartile range for continuous variables and as percentages for categorical variables. Differences in demographic characters between 4 groups were compared using Kruskal-Wallis Test for continuous variables and Pearson chi-square and Fisher’s exact test for categorical variables. Time to event between the groups was compared using Kaplan-Meier estimates and log rank test. Association between the risk factors and hepatotoxicity was computed using Odds Ratios (ORs). All statistical analysis was performed in Vasserstats: Statistical computation website.