ArticleHIV medicine2012
Elevated alanine aminotransferase in antiretroviral-naïve HIV-infected African patients: magnitude and risk factors.
Article in HIV medicine, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 3 of them syntheses that pooled it.
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Who cites it
14 citing papers in PubMed, 3 syntheses or guidelines pooled it, 22 citations in OpenAlex.
- Prevalence of cardiometabolic diseases among ART-naïve people with HIV: A global systematic review and meta-analysis.HIV medicine · 2026Pooled it
- Prevalence and influences of diabetes and prediabetes among adults living with HIV in Africa: a systematic review and meta-analysis.Journal of the International AIDS Society · 2023Pooled it
- Prevalence of hepatotoxicity among HIV-infected patients in Ethiopia: a systematic review and meta-analysis.BMC infectious diseases · 2022Pooled it
- Effect of high-dose multivitamin supplements on alanine aminotransferase elevations among adults living with HIV on antiretroviral therapy in Tanzania.BMC nutrition · 2024Article
- Liver Injury Patterns and Hepatic Toxicity among People Living with and without HIV and Attending Care in Urban Uganda.International journal of hepatology · 2023Article
- Persistent High Burden and Mortality Associated With Advanced HIV Disease in Rural Tanzania Despite Uptake of World Health Organization "Test and Treat" Guidelines.Open forum infectious diseases · 2022Article
- The Correlated Risk Factors for Severe Liver Damage Among HIV-Positive Inpatients With Abnormal Liver Tests.Frontiers in medicine · 2022Article
- Article
- Chronic hepatitis B-associated liver disease in the context of human immunodeficiency virus co-infection and underlying metabolic syndrome.World journal of virology · 2020Review
- Use of pre-ART laboratory screening to identify renal, hepatic and haematological abnormalities in Côte d'Ivoire.Tropical medicine & international health : TM & IH · 2020Article
- Modelling immune deterioration, immune recovery and state-specific duration of HIV-infected women with viral load adjustment: using parametric multistate model.BMC public health · 2020Article
- Imbalance of antioxidant enzymes activities and trace elements levels in Ghanaian HIV-infected patients.PloS one · 2019Article
- Management of HIV Infection during Pregnancy in the United States: Updated Evidence-Based Recommendations and Future Potential Practices.Infectious diseases in obstetrics and gynecology · 2016Review
- Risk Factors for Alanine Aminotransferase Elevations in a Prospective Cohort of HIV-Infected Tanzanian Adults Initiating Antiretroviral Therapy.Journal of the International Association of Providers of AIDS CareArticle
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundAlanine aminotransferase (ALT) is commonly used to measure liver injury in resource-limited settings. Elevations in ALT are predictive of increased mortality from liver disease and may influence the choice of first-line antiretroviral therapy (ART).
methodsA cross-sectional analysis of the prevalence and predictors of elevated ALT (defined as >40 IU/L) was conducted. ART-naïve, HIV-infected adults with a baseline ALT measurement who were enrolled in any of the 18 HIV Care and Treatment Clinics in Dar es Salaam, Tanzania between November 2004 and December 2009 were included in the study. Median values were calculated and log-binomial regression models were used to examine predictors of elevated ALT.
resultsDuring the study period, 41891 adults had a baseline ALT measurement performed. The prevalence of ALT >40, >120 and >200 IU/L was 13, 1 and 0.3%, respectively. In multivariate analyses, male sex, CD4 T lymphocyte count <200 cells/μL and higher World Health Organization (WHO) clinical stages were associated with a significantly higher risk of ALT >40 IU/L (all P<0.01). Hypertryglyceridaemia, hyperglycaemia and hepatitis B virus (HBV) coinfection (positive for HBV surface antigen) were significantly associated with a higher risk of elevated ALT. Pregnancy, anaemia, low-density lipoprotein cholesterol >130 mg/dL and current tuberculosis treatment were associated with a significantly reduced risk for elevated ALT.
conclusionsIn this HIV-infected, ART-naïve Tanzanian population, extreme elevations in ALT were infrequent but minor elevations were not uncommon. Antiretrovirals with potentially hepatotoxic side effects should be initiated with caution in male patients, and in patients with HBV coinfection, advanced immunosuppression and components of the metabolic syndrome.
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