Abstract

Alanine aminotransferase (ALT) is a hepatic enzyme that could be used as markers of hepatocellular injury. Liver enzyme elevations are frequent in human immune deficiency virus (HIV)-infected patients which may be caused by the HIV virus in those without other risk factors for liver damage. This study was designed to evaluate the correlation between HIV viral load and serum levels of ALT, a marker of hepatic damage. This was a cross-sectional analytic study performed among HIV infected naive patients without other risk factor for liver disease. The results of the study shows that of the 166 participants recruited into this study, 104 (62.7%) were females. The participants’ mean CD4 count was 180.04 ± 38.08 (95% confidence interval (CI), 164.11 to 195.96). The mean viral load log₁₀ (copies/ml) was 5.18 ± 4.28, and ALT (UI/L) was 24.80 ± 1.29 (95% CI, 22.26 to 27.35). Sixty (36.2%) of the studied participants had high viral load ≥ 100,000 copies/ml, while 22 (13.3%) had high ALT (≥ 40 IU/L). A positive correlation (Pearson correlation coefficient, r = 0.274, P = 0.000) between HIV viral load and ALT was observed. After adjusting for age, sex and CD4 count in a multivariable linear regression model, the correlation between HIV viral load and ALT remained significant (p = 0.003). The finding of positive correlation between HIV viral load and ALT levels in HIV infected naive patients suggests a linear relation between ALT level and HIV-1 viral load in HIV patients without other risk factor for liver damage. We recommend evaluating patients with high ALT for early anti-retroviral therapy (ART) in those without risk factor for liver damage regardless of the CD4+ cell count, especially where facility for estimating viral load is not available.

Key words: Alanine aminotransferase, human immune deficiency (HIV), viral load, CD4 count