Ikuabe Peter Ogie, Ebuenyi Ikenna Desmond, Harry Tubonye Clement
Niger J Med. 2015 Apr-Jun;24(2):103-7.
This study, undertaken in a major tertiary hospital in the Niger Delta region of Nigeria was designed to examine the incidence of elevation in serum alanine aminotransference (ALT) in our patients who were on treatment for HIV/AIDS with some of them on antituberculosis drugs.
Between January and December 2014, all admission records which include HIV status, Acid fast bacilli Status, Chest radiograph, CD4 cell count, degree of hepatotoxicity during antituberculosis drugs treatment according to WHO definition using clinical findings and ALT levels at baseline (ALTI) and at 4 weeks into treatment with antituberculosis drugs (ALT2) of all the patients on HAART with some on antituberculosis drugs were retrieved and retrospectively analyzed.
Of the total of 707 patients on HAART, 80 were on both HAART and anti-tuberculosis treatment.There was a statistically significant correlation between ALT I levels in the PTB negative and PTB positive cohort at baseline χ2 10.725,d.f4,P = 0.030. After 4 weeks of antituberculosis treatment and HAART ALT2 level in expectedly, generally showed downward trend with no statistically significant correlation between PTB status and ALT2 (χ2 = 0.789, d.f2.P = 0.674) CONCLUSION: Anti-tuberculosis drug induced elevation in alanine amino transference is unexpectedly low in our patients on treatment for pulmonary tuberculosis and HIV infection. This is a key finding that requires further studies.
本研究在尼日利亚尼日尔三角洲地区的一家大型三级医院开展,旨在调查接受抗逆转录病毒治疗的艾滋病患者以及部分同时接受抗结核药物治疗的患者血清丙氨酸氨基转移酶(ALT)升高的发生率。
检索并回顾性分析了2014年1月至12月期间所有患者的入院记录,包括HIV状态、抗酸杆菌状态、胸部X光片、CD4细胞计数、根据世界卫生组织定义使用临床检查结果评估的抗结核药物治疗期间的肝毒性程度,以及所有接受高效抗逆转录病毒治疗(HAART)且部分接受抗结核药物治疗的患者的基线ALT水平(ALTI)和抗结核药物治疗4周时的ALT水平(ALT2)。
在总共707例接受HAART治疗的患者中,有80例同时接受HAART和抗结核治疗。基线时,PTB阴性和PTB阳性队列的ALT I水平之间存在统计学显著相关性(χ2 = 10.725,自由度 = 4,P = 0.030)。抗结核治疗和HAART治疗4周后,ALT2水平如预期般总体呈下降趋势,PTB状态与ALT2之间无统计学显著相关性(χ2 = 0.789,自由度 = 2,P = 0.674)。结论:在我们治疗的肺结核和HIV感染患者中,抗结核药物引起的丙氨酸氨基转移酶升高出乎意料地低。这是一个需要进一步研究的关键发现。