A report by researchers at Emory University in Atlanta, Georgia, summarized the relation between immune reconstitution, antiretroviral-induced liver enzyme elevation, and HBV or HCV coinfection. Results were published in the November 2007 American Journal of the Medical Sciences.

Medical records of antiretroviral-naive HIV-infected patients initiating antiretroviral therapy at an urban HIV clinic were reviewed for hepatitis coinfection, moderate or greater liver enzyme elevations (grade > 2 ALT/AST elevation), and changes in CD4 cell counts over time.

Results

Conclusion

Based on their findings, the study authors concluded that a "more robust immune restoration" was noted in HIV-HBV or HIV-HCV coinfected subjects who developed liver enzyme elevation after antiretroviral initiation, compared with other groups.

In addition, they noted, "This finding suggests that antiretroviral-related liver enzyme elevation may be related in part to immune reconstitution, as measured by changes in CD4 T-cell counts."

From the Division of Infectious Disease, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia; Emory University School of Medicine, Atlanta, Georgia; the Center for AIDS Research, Atlanta, Georgia; Rollins School of Public Health, Emory University, Atlanta, Georgia; and the Grady Infectious Disease Program, Atlanta, Georgia.

12/07/07

Reference
I Ofotokun, SE Smithson, C Lu, and others. Liver Enzymes Elevation and Immune Reconstitution Among Treatment-Naïve HIV-Infected Patients Instituting Antiretroviral Therapy. American Journal of the Medical Sciences 334(5): 334-341. November 2007.