Liver function in children with human immunodeficiency virus infection before and after 6 months of highly active antiretroviral therapy

Eva Jacomina Jemima Sapulete; I Gusti Ngurah Sanjaya Putra; Ketut Dewi Kumara Wati; Hendra Santoso; I Putu Gede Karyana; Komang Ayu Witarini; Ni Nyoman Metriani Nesa

doi:10.14238/pi58.4.2018.159-64

Eva Jacomina Jemima Sapulete Department of Child Health, Udayana University Medical School/Sanglah Hospital, Denpasar, Bali
I Gusti Ngurah Sanjaya Putra Department of Child Health, Udayana University Medical School/Sanglah Hospital, Denpasar, Bali
Ketut Dewi Kumara Wati Department of Child Health, Udayana University Medical School/Sanglah Hospital, Denpasar, Bali https://orcid.org/0000-0002-6572-3694
Hendra Santoso Department of Child Health, Udayana University Medical School/Sanglah Hospital, Denpasar, Bali
I Putu Gede Karyana Department of Child Health, Udayana University Medical School/Sanglah Hospital, Denpasar, Bali
Komang Ayu Witarini Department of Child Health, Udayana University Medical School/Sanglah Hospital, Denpasar, Bali
Ni Nyoman Metriani Nesa Department of Child Health, Udayana University Medical School/Sanglah Hospital, Denpasar, Bali

DOI: https://doi.org/10.14238/pi58.4.2018.159-64

Keywords: liver function, pediatric, human immunodeficiency virus, antiretroviral

Abstract

Background Highly active antiretroviral therapy (HAART) has resulted in dramatic decreases in morbidity and improved survival rate in human immunodeficiency virus (HIV)-infected patients. Although the risk of morbidity has decreased, it has been replaced by other long-term complications, such as hepatotoxicity. Hepatotoxicity is often reflected in biochemical abnormalities of liver function, such as elevated levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), and aspartate aminotransferase-to-platelet ratio index (APRI).

Objective To compare liver function spectrum (AST, ALT, and APRI) in HIV-infected children before and after at least 6 months of HAART.

Methods This observational study (before and after) was conducted in pediatric patients with HIV infection who received HAART for at least 6 months at Sanglah Hospital, Denpasar. Data were collected from medical records.

Results Forty-nine patients were observed in this study. The mean AST, ALT, and APRI levels before HAART were higher than after at least 6 months of HAART. Anti-tuberculosis treatment and fluconazole therapy were not confounding factors for AST, ALT, and APRI.

Conclusion Liver function spectrum enzyme levels of AST, ALT, and APRI are improved after at least 6 months of HAART.

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