Association of Abnormal Liver Function Parameters with HIV Serostatus and CD4 Count in Antiretroviral-Naive Rwandan Women

Jean Claude Dusingize, Donald R. Hoover, Qiuhu Shi, Eugene Mutimura, Emmanuel Rudakemwa, Victorien Ndacyayisenga, Léonard Gakindi, Michael Mulvihill, Jean D.Amour Sinayobye, Emmanuel Musabeyezu, Kathryn Anastos

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

We determined the associations of HIV infection/CD4 count with markers of hepatocellular damage [elevated aspartate aminotransferase (AST) and alanine aminotransferase (ALT)] and liver synthetic function (decreased albumin) in HIV-infected (HIV(+)) antiretroviral therapy (ART)-naive and uninfected (HIV(-)) Rwandan women. In 2005, 710 HIV(+) ART-naive and 226 HIV(-) women enrolled in the Rwanda Women's Interassociation Study and Assessment. Liver enzymes were measured with abnormality defined as either AST or ALT ≥1.25 times the upper limit of normal. Low serum albumin level was defined as <3.5 g/dl. Multivariable logistic regression analysis identified independent predictors of elevated AST/ALT and low serum albumin. HIV(-) women had the lowest prevalence (6.6%) of abnormal AST/ALT, with the highest prevalence (16.4%) in HIV(+) women with CD4 <200 cells/μl (p=0.01). The odds of having serum albumin <3.5 g/dl was 5.7-fold higher in HIV(+) than HIV(-) women (OR=5.68, 95% CI: 3.32-9.71). The risk of low albumin decreased from low to high CD4 count, with OR=2.62, 95% CI: 1.66, 4.14 and OR=1.57, 95% CI: 1.01, 2.43 in HIV(+) women with a CD4 count <200 and 200-350 cells/μl, respectively vs. HIV(+) with CD4 >350 (p<0.001 and p<0.05 for all comparisons). Our findings suggest that HIV-associated liver damage may occur in ART-naive patients. Although liver abnormality prevalences in this cohort of HIV-infected Rwandan women are less than reported in developed countries, caution is needed for risk assessment measures to monitor and screen HIV-infected patients pre- and post-ART initiation in African clinical settings to curtail potential risks associated with HIV infection.

Original languageEnglish (US)
Pages (from-to)723-730
Number of pages8
JournalAIDS Research and Human Retroviruses
Volume31
Issue number7
DOIs
StatePublished - Jul 1 2015

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CD4 Lymphocyte Count
HIV
Liver
Aspartate Aminotransferases
Alanine Transaminase
HIV Infections
Rwanda
Therapeutics
Developed Countries
Serum Albumin
Albumins
Enzymes

ASJC Scopus subject areas

  • Immunology
  • Infectious Diseases
  • Virology

Cite this

Association of Abnormal Liver Function Parameters with HIV Serostatus and CD4 Count in Antiretroviral-Naive Rwandan Women. / Dusingize, Jean Claude; Hoover, Donald R.; Shi, Qiuhu; Mutimura, Eugene; Rudakemwa, Emmanuel; Ndacyayisenga, Victorien; Gakindi, Léonard; Mulvihill, Michael; Sinayobye, Jean D.Amour; Musabeyezu, Emmanuel; Anastos, Kathryn.

In: AIDS Research and Human Retroviruses, Vol. 31, No. 7, 01.07.2015, p. 723-730.

Research output: Contribution to journalArticle

Dusingize, JC, Hoover, DR, Shi, Q, Mutimura, E, Rudakemwa, E, Ndacyayisenga, V, Gakindi, L, Mulvihill, M, Sinayobye, JDA, Musabeyezu, E & Anastos, K 2015, 'Association of Abnormal Liver Function Parameters with HIV Serostatus and CD4 Count in Antiretroviral-Naive Rwandan Women', AIDS Research and Human Retroviruses, vol. 31, no. 7, pp. 723-730. https://doi.org/10.1089/AID.2014.0170
Dusingize, Jean Claude ; Hoover, Donald R. ; Shi, Qiuhu ; Mutimura, Eugene ; Rudakemwa, Emmanuel ; Ndacyayisenga, Victorien ; Gakindi, Léonard ; Mulvihill, Michael ; Sinayobye, Jean D.Amour ; Musabeyezu, Emmanuel ; Anastos, Kathryn. / Association of Abnormal Liver Function Parameters with HIV Serostatus and CD4 Count in Antiretroviral-Naive Rwandan Women. In: AIDS Research and Human Retroviruses. 2015 ; Vol. 31, No. 7. pp. 723-730.
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