Alterations of alpha fetoprotein and some liver enzymes, in HIV patients undergoing antiretroviral therapy at Federal Medical Centre, Owerri
Aim: This study is therefore aimed at evaluating the serum level of alpha fetoprotein and liver enzymes in HIV patients undergoing antiretroviral therapy at Federal Medical Centre, Owerri. Materials and method: A total of one hundred and fifty subjects which comprised 50 HIV patients on antiretroviral therapy, 50 HIV patients not yet on antiretroviral therapy and 50 healthy subjects as control were used in the study. The liver enzymes and alpha fetoprotein serum levels were determined using colorimetric end-point method and ELISA technique, respectively. Statistical analysis was performed on Statistical Package for Social Science (SPSS) windows version 20.0.Test of significance was determined using the student’s t-test and the statistical significance was set up at p<0.05.Results:. Results obtained showed a significant increase (p<0.05) in alpha fetoprotein (4.64±4.42ng/ml), Aspartate aminotransferase (13.3±8.10iu/L), Alanine Aminotransferase (7.58±3.56iu/L) and alkaline phosphatase (68.73±54.95iu/L) of the HIV positive patients when compared with to their controls (1.43±1.53ng/ml), (5.75±3.03iu/L), (3.85±2.33iu/L) (25.9±9.17iu/L) respectively. There were no significant difference (P>0.05) in the mean value of the alpha fetoprotein of those already in ART (5.91±5.60ng/ml) when compared with the mean value seen in those not on the therapy (3.36±2.10ng/ml). Also, when compared according to duration of therapy, a significant increase was seen at P>0.05 in all the parameters. This study inferred that long time use of these antiretrovirals has a damaging effect on the liver but can't possibly cause hepatocellular carcinoma except in the presence of other risk factors. Thus, the intake of the drug should be strictly under the doctor's prescription and monitoring.
2. Eisinger, R. W., Dieffenbach, C. W and Fauci A. S. (2019). HIV viral load and transmissibility of HIV infection: Undetectable equals untransmittable. JAMA. 321 (5): 451–452
3. Deeks, S. G., Lewin, S. R and Havlir, D. V. (2018). The end of AIDS: HIV infection as a chronic disease. Lancet. 382 (9903): 1525-1533.
4. May, M.T., Gompels, M., Delpech, V., Porter, K., Orkin, C and Kegg S. (2015). Impact on life expectancy of HIV-1 positive individuals of CD4+ cell count and viral load response to antiretroviral therapy.AIDS. 28(8):1193–1202
5. Marcus, J. L., Chao, C. R., Leyden, W. A., Xu, L., Quesenberry, C. P and Jr, Klein, D. B. (2016). Narrowing the gap in life expectancy between HIV-infected and HIV-uninfected individuals with access to care.Journal of Acquired Immune Deficiency Syndrome. 73(1):39–46.
6. Murphy, E. L., Collier, A. C and Kalish, L. A. (2007). Highly Active antiretrovial therapy decreases mortality and morbidity in patients with advanced HIV disease. Annual international medicine.135:17-26.
7. Abdel-Misih, Sherif, Bloomston and Mark (2010). Liver Anatomy.Surgical Clinics of North America.90 (4): 643–653.
8. Bica, I., McGovern, B., Dear, R., Stone, D., McGowan, K and Scheib, R. (2011).Increasing mortality due to end stage liver disease in patients with human immunodeficiency virus infection.Clinical Infection Disease. 32:492-497.
9. Nwanjo, H. U. (2006). The liver in : Functional test of organs. 2nd Edition.Hacyn Publishers, Owerri. PP 34-69.
10. Tomasi, T. B. (2000). Structure and function of alpha-fetoprotein.Annual Review of Medicine. 28: 453–465.
11. Ertle, J. M., Heider, D., Wichert, M., Keller, B., Kueper, R., Hilgard, P., Gerken, G and Schlaak, J. F. (2017). A combination of α-fetoprotein and des-γ-carboxyprothrombin is superior in detection of hepatocellular carcinoma. Digestion. 87 (2): 121–131.
12. Clifford, G.M., Rickenbach, M and Polesel, J. (2016). Influence of HIV- related immunodeficiency on the risk of hepatocellular carcinoma. AIDS.
13. Haggerty, C.M., Pitt, E and Siliciano, R. F. (2016). The latent reservoir for HIV-1 in resting CD4+ T cells and other viral reservoirs during chronic infection: insights from treatment and treatment-interruption trials. Current Opinion on HIV AIDS.1(1):62–68.
14. Henry, J, B. (1996). Clinical diagnosis and management by laboratory methods. WB Saunders Company. PP. 1075.
15. Reitman, S and Frankel, S, A (1957). Colorimetric method for the determination of serum glutamic oxalacetic and glutamic pyruvic transaminases. American journal of Clinical Patholology.28:56.
16. Tietz, N. (1976). Fundamentals of Clinical Chemistry.602-609.
17. Smith, C., Sabin, C, A and Lundgren, J, D. (2010). Factors associated with specific causes of death amongst HIV-positive individuals in the D:A:DStudy.AIDS . 24(10):1537–154819. Reust, C. E. (2015). Common adverse effects of antiretroviral therapy for HIV disease.American Family Physician. 83(12):1443–1451.
19. Reust, C. E. (2015). Common adverse effects of antiretroviral therapy for HIV disease.American Family Physician. 83(12):1443–1451.
18. Campell, M. S. (2011). Hepatobiliary manifestation of the acquired immune deficiency syndrome.American Journal Gastroenterol.88: 1 -15.
20. Bissell, D., Gores, G., Laskin, D and Hoofnagle. (2010). Drug-induced liver injury: mechanisms and test systems. Hepatology. 33: 1009–1013
21. Lafon, M. E., Steffan, A. M and Royer, C. (2007). HIV-1 infection induces functional alterations in human liver endothelial cells in primary culture. Aids. 8(6):747–752.
22. Grulich, A. E., Li, Y, McDonald, A. M., Correll, P.K., Law, M.G and Kaldor, J, M. (2011).Decreasing rates of Kaposi's sarcoma and non-Hodgkin's lymphoma in the era of potent combination anti-retroviral therapy.AIDS. 15:629–633.
23.Abelev, G. I. (2005). Production of embryonal serum alpha-globulin by hepatomas: review of experimental and clinical data. Cancer Research. 28:1344–1350.
24. Bedimo, R. (2008). Non-AIDS-defining malignancies among HIV-infected patients in the highly active antiretroviral therapy era.Current HIV/AIDS reports. 5:140–149.
Copyright (c) 2020 Journal of Progressive Research in Biology
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
JPRB is pleased to undertake the publication of your contribution to Journal of Progressive Research in Biology.
The copyright to this article is transferred to JPRB(including without limitation, the right to publish the work in whole or in part in any and all forms of media, now or hereafter known) effective if and when the article is accepted for publication thus granting JPRB all rights for the work so that both parties may be protected from the consequences of unauthorized use.