Author/Authors :
Wu, Lijuan Department of Nursing - School of Medicine - Taizhou University, Taizhou , Jin, Changzhong State Key Laboratory for Diagnosis and Treatment of Infectious Disease - The First Affiliated Hospital - School of Medicine - Zhejiang University, Hangzhou , Wu, Nanping State Key Laboratory for Diagnosis and Treatment of Infectious Disease - The First Affiliated Hospital - School of Medicine - Zhejiang University, Hangzhou , Bai, shi Department of Basic Medicine - School of Medicine - Taizhou University, Taizhou , Davies, Henry Department of Basic Medicine - School of Medicine - Zhejiang University, Hangzhou , Rao, Heping Department of Nursing - School of Medicine - Quzhou College of Technology, Quzhou , Liang, Yong Department of Oncology - School of Medicine - Taizhou University - Taizhou 318000, China
Abstract :
Background: Co-infection of hepatitis virus is common in human immunodeficiency virus (HIV) infected adults in China. But little
is known about hepatitis virus co-infection in pediatric HIV-infected subjects. The study aimed to investigate the impact of hepatitis
B virus (HBV) and/or hepatitis C virus (HCV) co-infection and highly active antiretroviral therapy (HAART) on liver function
of pediatric HIV-infected subjects. Materials and Methods: A cohort study including 101 pediatric HIV-infected subjects with
HBV/HCV co-infection and 44 pediatric comparators with HIV mono-infection was carried out in Henan Province of China from
September 2011 to September 2012. All patients received HAART for 1-year. HBV and HCV infection was determined by antibody
tests. HIV RNA load, CD4+ T-cell counts and liver function were determined before and after HAART. The Student’s t-test or a
one-way ANOVA was used for normally distributed values and A Mann-Whitney U-test was performed for values without normal
distribution using SPSS statistical package 18.0 (SPSS Inc.). Results: After HAART for 1-year, the median levels of viral load were
decreased to lower limit of detection in 90.34% pediatric HIV-infected subjects with/without HBV/HCV co-infection (P < 0.001),
and CD4+ T-cell counts increased significantly (P < 0.001). Compared with the pre-HAART, mean level of alanine aminotransferase
(ALT) in each group had a significant increase after HAART (P < 0.01). The mean levels of ALT and aspartate aminotransferase
(AST) in nevirapine (NVP) based HAART group increased significantly after HAART (P < 0.01). Mean change values of ALT and
AST were significantly higher in the NVP based regimen group than in the efavirenz (EFV) based regimen group (P < 0.01). For HIV/
HBV/HCV co-infected patients, mean change values of ALT and AST in NVP-based HAART group was significantly higher than
that in EFV-based HAART group (P < 0.01). Conclusion: Highly active antiretroviral therapy can damage liver function in pediatric
HIV-infected subjects, especially in those with HBV/HCV co-infection. NVP was more harmful to liver function of pediatric HIVinfected
subjects than EFV.
Keywords :
pediatric , liver function , human immunodeficiency virus , highly active antiretroviral therapy , hepatitis C virus , hepatitis B virus , Co-infection
