RESEARCH ARTICLE


Liver Enzyme Alterations in HCV-Monoinfected and HCV/HIV-Coinfected Patients



Klaus Langohr1, 2, Arantza Sanvisens1, Daniel Fuster1, Jordi Tor1, Isabel Serra1, Celestino Rey-Joly1, Inmaculada Rivas3, Roberto Muga*, 1
1 Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
2 Human Pharmacology and Clinical Neurosciences Research Unit. Institut Municipal d'Investigació Mèdica / IMIM, Barcelona, Spain
3 Municipal Centre for Drug Abuse Treatment (Centro Delta), Badalona, Spain


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© Langohr et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol. Room 806, Carretera Canyet s/n, 08916 Badalona, Barcelona, Spain; Tel: (+34) 93-497 89 14; Fax: (+34) 93-497 88 43; E-mail: rmuga.germanstrias@gencat.cat


Abstract

Hepatitis C virus (HCV) is the most common blood-borne infection in developed countries and co-infection with the Human Immunodeficiency Virus (HIV) is frequent in individuals with history of injecting drug use (IDU).

We aimed to analyze liver transaminases in HCV monoinfected and HCV/HIV co-infected patients to assess the effect of HIV infection on liver enzyme elevations.

We studied 429 current IDUs admitted to substance abuse treatment (82.5% males). Serum samples for liver tests, HIV infection and viral hepatitis serologies were obtained at admission. Results: Median age was 30 years (IQR:27-34), median duration of IDU was 10 years (IQR:5-14), 52% of patients were HCV/HIV co-infected, 40.8% were HCV monoinfected, and 7.2% were HCV and HIV- seronegatives. Elevated AST was associated with male gender and lower CD8+ cell count in the HCV monoinfected patients, and with age and lower cholesterol in the HCV/HIV coinfected subjects. ALT elevation was associated with younger age, higher body mass index and male gender in the monoinfected patients, and with higher CD4+ cell counts and lower cholesterol in the co-infected group. Male sex was strongly associated with elevated ALT and AST transaminase in the monoinfected but not in dual-infected subjects.

These data suggest that the effect of gender on liver enzymes may be lost in patients with HIV infection. The overall differences observed between groups regarding liver enzyme elevations are of clinical relevance in the management of IDUs with chronic hepatitis C.

Keywords: Aspartate aminotransferase (AST), alanine aminotransferase (ALT), correlates of hepatic transaminase elevations, HIV/hepatitis C co-infection, injection drug users..