Hepatic Function and its Association with Clinical Outcomes in Non-Adherent HIV-1 Adults ‎‎

Background and study aim: Hepatic derangements are emerging as prominent causes mortality and morbidity among HIV patients on Highly Active Antiretroviral therapy (HAART). Among this population, high HIV viremia, low CD4+ count and HAART have been established as risk factors for hepatic injury. Although HAART mitigates these risks, it is unknown whether non-adherence to it contributes to the development of hepatic derangements. The current study aimed at exploring whether non-adherence to HAART affects hepatic function of HIV-1 infected adults and to associate hepatic function makers with Viral loads, Body mass index and CD4+ counts of the same population. Materials and Methods: ‎‎‎ This cross-sectional analytical study targeted HIV-1 infected adults on first-line HAART comprising of Tenofovir Disoproxil Fumarate, Lamivudine and Efavirenz. A total of 163 adult participants were enrolled. Adherence to HAART was calculated using Pharmacy refill records. Hepatic enzyme levels were measured using a Mindray BS-200 automated clinical chemistry analyzer. Descriptive statistics, Kruskal Wallis test and Bonferroni post hoc statistical tests were performed using SPSS version 25‎.‎ Results: Levels of total protein and globulin were elevated among HAART non-adherent participants relative to HAART adherent participants. Furthermore, Albumin to total protein and albumin to globulin ratios were lower in the HAART non-adherent participants relative to the HAART adherent group. CD4+ counts positively correlated with globulin levels. However, levels of Aspartate transaminase, Alanine transaminase, Alkaline phosphatase and Gamma glutamyl transferase were similar between HAART non-adherent and HAART adherent participants‎. Conclusion: Non-adherence to HAART dysregulates hepatic globulin synthesis without significant hepatic damage ‎‎.