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Liver function test abnormalities in a longitudinal cohort of Thai individuals treated since acute HIV infection
INTRODUCTION: Liver disease is a common cause of non‐AIDS morbidity and mortality in people living with HIV (PLHIV), but the prevalence and significance of liver function test (LFT) abnormalities in early HIV infection is unknown. This study aimed to characterize LFTs in a large cohort of participan...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6968973/ https://www.ncbi.nlm.nih.gov/pubmed/31953919 http://dx.doi.org/10.1002/jia2.25444 |
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author | Peluso, Michael J Colby, Donn J Pinyakorn, Suteeraporn Ubolyam, Sasiwimol Intasan, Jintana Trichavaroj, Rapee Chomchey, Nitiya Prueksakaew, Peeriya Slike, Bonnie M Krebs, Shelly J Jian, Ningbo Robb, Merlin L Phanuphak, Praphan Phanuphak, Nittaya Spudich, Serena Ananworanich, Jintanat Kroon, Eugène Teeratakulpisarn, Nipat Pattanachaiwit, Supanit Sacdalan, Carlo Sriplienchan, Somchai de Souza, Mark Tantivitayakul, Ponpen Poltavee, Kultida Luekasemsuk, Tassanee Savadsuk, Hathairat Tipsuk, Somporn Puttamsawin, Suwanna Benjapornpong, Khunthalee Ratnaratorn, Nisakorn Tangnaree, Kamonkan Munkong, Chutharat Thaimanee, Rommanus Eamyoung, Patcharin Buranapraditkun, Supranee Lerdlum, Sukalya Manasnayakorn, Sopark Rerknimitr, Rugsun Sirivichayakul, Sunee Wattanaboonyongcharoen, Phandee Suttichom, Duanghathai O'Connell, Robert Schuetz, Alexandra Hsu, Denise Akapirat, Siriwat Nuntapinit, Bessara Tantibul, Nantana Churikanont, Nampueng Getchalarat, Saowanit Michael, Nelson Vasan, Sandhya Crowell, Trevor Turk, Ellen McCullough, Corinne Butterworth, Oratai Milazzo, Mark Anne Eller, Leigh |
author_facet | Peluso, Michael J Colby, Donn J Pinyakorn, Suteeraporn Ubolyam, Sasiwimol Intasan, Jintana Trichavaroj, Rapee Chomchey, Nitiya Prueksakaew, Peeriya Slike, Bonnie M Krebs, Shelly J Jian, Ningbo Robb, Merlin L Phanuphak, Praphan Phanuphak, Nittaya Spudich, Serena Ananworanich, Jintanat Kroon, Eugène Teeratakulpisarn, Nipat Pattanachaiwit, Supanit Sacdalan, Carlo Sriplienchan, Somchai de Souza, Mark Tantivitayakul, Ponpen Poltavee, Kultida Luekasemsuk, Tassanee Savadsuk, Hathairat Tipsuk, Somporn Puttamsawin, Suwanna Benjapornpong, Khunthalee Ratnaratorn, Nisakorn Tangnaree, Kamonkan Munkong, Chutharat Thaimanee, Rommanus Eamyoung, Patcharin Buranapraditkun, Supranee Lerdlum, Sukalya Manasnayakorn, Sopark Rerknimitr, Rugsun Sirivichayakul, Sunee Wattanaboonyongcharoen, Phandee Suttichom, Duanghathai O'Connell, Robert Schuetz, Alexandra Hsu, Denise Akapirat, Siriwat Nuntapinit, Bessara Tantibul, Nantana Churikanont, Nampueng Getchalarat, Saowanit Michael, Nelson Vasan, Sandhya Crowell, Trevor Turk, Ellen McCullough, Corinne Butterworth, Oratai Milazzo, Mark Anne Eller, Leigh |
author_sort | Peluso, Michael J |
collection | PubMed |
description | INTRODUCTION: Liver disease is a common cause of non‐AIDS morbidity and mortality in people living with HIV (PLHIV), but the prevalence and significance of liver function test (LFT) abnormalities in early HIV infection is unknown. This study aimed to characterize LFTs in a large cohort of participants with acute HIV infection initiating immediate antiretroviral therapy (ART) and examine the association between LFTs and biomarkers of HIV infection and inflammation. METHODS: We measured LFTs at the time of HIV diagnosis and at 4, 12, 24 and 48 weeks after ART initiation in 426 Thai individuals with acute HIV infection from 2009 to 2018. A subset of individuals had data available at 96 and 144 weeks. We excluded individuals with concomitant viral hepatitis. Alanine aminotransferase (ALT) was the primary outcome of interest; values greater than 1.25 times the upper limit of normal were considered elevated. Analyses utilized descriptive statistics, non‐parametric tests and multivariate logistic regression. RESULTS: Sixty‐six of the 426 individuals (15.5%) had abnormal baseline ALT levels; the majority (43/66, 65.5%) had Grade 1 elevations. Elevated baseline ALT correlated with Fiebig stages III to V (p = 0.001) and baseline HIV RNA >6 log(10) copies/mL (p = 0.012). Baseline elevations resolved by 48 weeks on ART in 59 of the 66 individuals (89%). ALT elevations at 24 and 48 weeks correlated with Fiebig stages I to II at diagnosis (p < 0.001), baseline plasma HIV RNA levels <6 log(10) copies/mL (p < 0.001), abnormal baseline ALT (p < 0.001), baseline CD4 >350 cells/μL (p = 0.03) and older age (p = 0.03). Individuals initiating efavirenz‐based regimens were more likely to have elevated ALT levels at 48 weeks compared with those on non‐efavirenz‐based regimens (p = 0.003). CONCLUSIONS: One in six people with acute HIV infection have elevated LFTs. Clinical outcomes with ART started in acute HIV are generally good, with resolution of ALT elevations within 48 weeks on ART in most cases. These results suggest a multifactorial model for hepatic injury involving a combination of HIV‐associated and ART‐associated processes, which may change over time. |
format | Online Article Text |
id | pubmed-6968973 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-69689732020-01-27 Liver function test abnormalities in a longitudinal cohort of Thai individuals treated since acute HIV infection Peluso, Michael J Colby, Donn J Pinyakorn, Suteeraporn Ubolyam, Sasiwimol Intasan, Jintana Trichavaroj, Rapee Chomchey, Nitiya Prueksakaew, Peeriya Slike, Bonnie M Krebs, Shelly J Jian, Ningbo Robb, Merlin L Phanuphak, Praphan Phanuphak, Nittaya Spudich, Serena Ananworanich, Jintanat Kroon, Eugène Teeratakulpisarn, Nipat Pattanachaiwit, Supanit Sacdalan, Carlo Sriplienchan, Somchai de Souza, Mark Tantivitayakul, Ponpen Poltavee, Kultida Luekasemsuk, Tassanee Savadsuk, Hathairat Tipsuk, Somporn Puttamsawin, Suwanna Benjapornpong, Khunthalee Ratnaratorn, Nisakorn Tangnaree, Kamonkan Munkong, Chutharat Thaimanee, Rommanus Eamyoung, Patcharin Buranapraditkun, Supranee Lerdlum, Sukalya Manasnayakorn, Sopark Rerknimitr, Rugsun Sirivichayakul, Sunee Wattanaboonyongcharoen, Phandee Suttichom, Duanghathai O'Connell, Robert Schuetz, Alexandra Hsu, Denise Akapirat, Siriwat Nuntapinit, Bessara Tantibul, Nantana Churikanont, Nampueng Getchalarat, Saowanit Michael, Nelson Vasan, Sandhya Crowell, Trevor Turk, Ellen McCullough, Corinne Butterworth, Oratai Milazzo, Mark Anne Eller, Leigh J Int AIDS Soc Research Articles INTRODUCTION: Liver disease is a common cause of non‐AIDS morbidity and mortality in people living with HIV (PLHIV), but the prevalence and significance of liver function test (LFT) abnormalities in early HIV infection is unknown. This study aimed to characterize LFTs in a large cohort of participants with acute HIV infection initiating immediate antiretroviral therapy (ART) and examine the association between LFTs and biomarkers of HIV infection and inflammation. METHODS: We measured LFTs at the time of HIV diagnosis and at 4, 12, 24 and 48 weeks after ART initiation in 426 Thai individuals with acute HIV infection from 2009 to 2018. A subset of individuals had data available at 96 and 144 weeks. We excluded individuals with concomitant viral hepatitis. Alanine aminotransferase (ALT) was the primary outcome of interest; values greater than 1.25 times the upper limit of normal were considered elevated. Analyses utilized descriptive statistics, non‐parametric tests and multivariate logistic regression. RESULTS: Sixty‐six of the 426 individuals (15.5%) had abnormal baseline ALT levels; the majority (43/66, 65.5%) had Grade 1 elevations. Elevated baseline ALT correlated with Fiebig stages III to V (p = 0.001) and baseline HIV RNA >6 log(10) copies/mL (p = 0.012). Baseline elevations resolved by 48 weeks on ART in 59 of the 66 individuals (89%). ALT elevations at 24 and 48 weeks correlated with Fiebig stages I to II at diagnosis (p < 0.001), baseline plasma HIV RNA levels <6 log(10) copies/mL (p < 0.001), abnormal baseline ALT (p < 0.001), baseline CD4 >350 cells/μL (p = 0.03) and older age (p = 0.03). Individuals initiating efavirenz‐based regimens were more likely to have elevated ALT levels at 48 weeks compared with those on non‐efavirenz‐based regimens (p = 0.003). CONCLUSIONS: One in six people with acute HIV infection have elevated LFTs. Clinical outcomes with ART started in acute HIV are generally good, with resolution of ALT elevations within 48 weeks on ART in most cases. These results suggest a multifactorial model for hepatic injury involving a combination of HIV‐associated and ART‐associated processes, which may change over time. John Wiley and Sons Inc. 2020-01-17 /pmc/articles/PMC6968973/ /pubmed/31953919 http://dx.doi.org/10.1002/jia2.25444 Text en © 2020 The Authors. Journal of the International AIDS Society published by John Wiley & Sons Ltd on behalf of the International AIDS Society. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Articles Peluso, Michael J Colby, Donn J Pinyakorn, Suteeraporn Ubolyam, Sasiwimol Intasan, Jintana Trichavaroj, Rapee Chomchey, Nitiya Prueksakaew, Peeriya Slike, Bonnie M Krebs, Shelly J Jian, Ningbo Robb, Merlin L Phanuphak, Praphan Phanuphak, Nittaya Spudich, Serena Ananworanich, Jintanat Kroon, Eugène Teeratakulpisarn, Nipat Pattanachaiwit, Supanit Sacdalan, Carlo Sriplienchan, Somchai de Souza, Mark Tantivitayakul, Ponpen Poltavee, Kultida Luekasemsuk, Tassanee Savadsuk, Hathairat Tipsuk, Somporn Puttamsawin, Suwanna Benjapornpong, Khunthalee Ratnaratorn, Nisakorn Tangnaree, Kamonkan Munkong, Chutharat Thaimanee, Rommanus Eamyoung, Patcharin Buranapraditkun, Supranee Lerdlum, Sukalya Manasnayakorn, Sopark Rerknimitr, Rugsun Sirivichayakul, Sunee Wattanaboonyongcharoen, Phandee Suttichom, Duanghathai O'Connell, Robert Schuetz, Alexandra Hsu, Denise Akapirat, Siriwat Nuntapinit, Bessara Tantibul, Nantana Churikanont, Nampueng Getchalarat, Saowanit Michael, Nelson Vasan, Sandhya Crowell, Trevor Turk, Ellen McCullough, Corinne Butterworth, Oratai Milazzo, Mark Anne Eller, Leigh Liver function test abnormalities in a longitudinal cohort of Thai individuals treated since acute HIV infection |
title | Liver function test abnormalities in a longitudinal cohort of Thai individuals treated since acute HIV infection |
title_full | Liver function test abnormalities in a longitudinal cohort of Thai individuals treated since acute HIV infection |
title_fullStr | Liver function test abnormalities in a longitudinal cohort of Thai individuals treated since acute HIV infection |
title_full_unstemmed | Liver function test abnormalities in a longitudinal cohort of Thai individuals treated since acute HIV infection |
title_short | Liver function test abnormalities in a longitudinal cohort of Thai individuals treated since acute HIV infection |
title_sort | liver function test abnormalities in a longitudinal cohort of thai individuals treated since acute hiv infection |
topic | Research Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6968973/ https://www.ncbi.nlm.nih.gov/pubmed/31953919 http://dx.doi.org/10.1002/jia2.25444 |
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