Hepatotoxicity in patients receiving HAART therapy: Clinical profile & Risk factors.

Karthikeyan, P (2007) Hepatotoxicity in patients receiving HAART therapy: Clinical profile & Risk factors. Masters thesis, Madras Medical College, Chennai.

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Abstract

INTRODUCTION : HIV infection/AIDS is a global pandemic with cases reported from virtually every country. The current estimate of cases among adults is estimated to be around 37 million. Two thirds of them live in Sub Saharan Africa and 50% are women. The prevalence ranges from 0.6% to 8% in different parts of the world. Gastroenterological manifestations are quite common in advanced HIV infection/ AIDS and are some times initial manifestations or AIDS defining illness. Liver involvement is unique since it can be because of direct involvement, opportunistic infections (OI ) with r co-infection of one or more hepatotrophic viruses, or because of toxicity due to retroviral drugs. AIM OF THE STUDY : The study was conducted with the objective of 1. estimate the incidence of drug induced hepatotoxicity in patient receiving HAART therapy for HIV/AIDS. 2. to analyze the risk factors that are associated with drug induced hepatotoxicity in these patients and their clinical profile. CONCLUSIONS : The following were concluded at the end of the study: 1. Drug induced liver injury occurs in 3.9% of patients following HAART therapy 2. The risk factors for hepatotoxicity identified were Low BMI, Low CD4 count, HBV co-infection, and combined HBV co-infection & alcohol usage. 3. Age, Sex, alcohol usage alone, various regimens did not have any correlation with the incidence and severity of hepatotoxicity. 4. The occurrence of rash or constitutional symptoms had poor sensitivity and specificity for drug induced hepatotoxicity in these patients. SUMMARY : The study was initiated with the primary aim of finding out the clinical profile and risk factors for the hepatotoxicity in patients receiving HAART therapy for AIDS. A total of 1523 patients were screened and patients who developed liver injury during ART therapy were selected. About 50 adult patients of both the sexes were included in the study. Records of these patients were analyzed. Further testing was done as needed. Various parameters were noted. Statistical analysis was done by Oneway ANOVA F test, Chi-squared test and Student independent t test, in which correlation between various parameters and hepatotoxicity were analyzed. Results were tabulated and compared with various published series worldwide. According to our series, the major risk factors for hepatotoxicity were Hepatitis B infection, Low CD4 counts, Low BMI, alcohol abuse in HBV positive patients. The risk of liver injury was independent of age, sex, various drug combinations. Clinically, rash and constitutional symptoms occur in less than one quarter of these patients and carry poor sensitivity or specificity. These results were comparable with publishes series from various countries although subtle differences exist.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Hepatotoxicity ; patients ; HAART therapy ; Clinical profile ; Risk factors.
Subjects: MEDICAL > Gastroenterology
Depositing User: Kambaraman B
Date Deposited: 13 Jul 2017 04:04
Last Modified: 13 Jul 2017 04:04
URI: http://repository-tnmgrmu.ac.in/id/eprint/1553

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