Pattern of abnormal liver enzymes in HIV patients presenting at a Nigerian Tertiary Hospital

To demonstrate the pattern of abnormal liver enzymes in HIV patients presenting at the University of Port Harcourt Teaching Hospital, Port Harcourt.

Abnormalities of liver function tests (LFT) have been shown to be common in HIV/AIDS in developed countries. Studies have shown that these abnormalities may be due to direct inflammation induced by the HIV virus on the liver cell. It may also be due to gall bladder disease and infection with bacterial, viral or other opportunistic agents.

We reviewed the clinical notes and biochemistry results of HIV positive patients presenting at the HIV clinic from January 2003 to October 2003. Efforts were made to elicit symptoms suggestive of hepatobiliary disease. Their hepatitis B surface antigen status and their hepatitis C status were obtained. Attempts were made to determine the pattern of liver injury in each patient seen.

A total of one hundred and twenty -nine (129) cases were recruited. The mean age was 35.6 +/- 9.0 years with a male to female ratio of 1.1 : 1. One hundred and thirteen patients (87.6%) had abnormalities of their LFT'S. Sixteen of these (14.5%) were classified as cholestatic liver injury while ninety-four (85.5%) were classified as having hepatocellular injury. Three patients (2.3%) were HbSAg positive while one (0.8%) was hepatitis C antibody positive. None of the patients was on anti retroviral drugs at the time of recruitment.

We therefore conclude that abnormalities of liver enzymes are common in patients with HIV in this environment. It is therefore important to characterise the nature of this abnormality and to institute appropriate management. However further studies are required in this field of HIV related liver disease in our locality.