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All Journal Tropical Medicine Journal Jurnal Ilmu Kedokteran (Journal of Medical Science) Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Jurnal Farmasi Klinik Indonesia Jurnal Ilmu Farmasi dan Farmasi Klinik (Journal of Pharmaceutical Science and Clinical Pharmacy) Jurnal Pengabdian Kepada Masyarakat (Indonesian Journal of Community Engagement) INDONESIAN JOURNAL OF PHARMACY Jurnal Farmasi Sains dan Komunitas JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice) Molucca Medica Indonesian Journal of Pharmacology and Therapy
Jarir At Thobari
Department Of Pharmacology And Therapy, Faculty Of Medicine, Public Health And Nursing, Gadjah Mada University, Yogyakarta, 55281, Indonesia
Biochemistry, Genetics & Molecular Biology Decision Sciences, Operations Research & Management Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Early drug-induced hepatotoxicity in newly diagnosed HIV-positive patients on ARV therapy: A retrospective follow-up study of liver function profiles Chandra, Lukman Ade; Subronto, Yanri Wijayanti; Thobari, Jarir At
Indonesian Journal of Pharmacology and Therapy Vol 4 No 2 (2023)
Publisher : Faculty of Medicine, Public Health, and Nursing Universitas Gadjah Mada and Indonesian Pharmacologist Association or Ikatan Farmakologi Indonesia (IKAFARI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/ijpther.7817

Abstract

Antiretroviral therapy (ART) is a primary therapeutic modality for managing individuals with Human Immunodeficiency Virus (HIV) infection, and its efficacy has been established. However, the safety profiles of ART need to be continually monitored, including early elevated liver function test (LFT) after antiretroviral (ARV) initiation. This study aimed to assess the incidence of abnormal LFT among HIV-positive patients receiving initial ARV and to identify factors associated with abnormal LFT. A retrospective cohort study without a control group summarised medical records from Dr Sardjito General Hospital, Yogyakarta between January 2014 and December 2021. The study subjects were adult HIV patients taking their first ARV and underwent follow-up visits for at least two weeks. Study outcomes were LFT levels, abnormal LFT, and factors associated with abnormal LFT during follow-up visits at 2 wk, 6 mo, and 12 mo. Univariate and multivariate analyses will be performed with a significance level of p<0.05. A total of 137 subjects with 203 visits were retrieved from medical records. The subjects' mean age was 33.4 years, predominantly male, younger, unmarried, in the early stage of HIV infection, and without comorbidities. The findings showed a significant increase in alanine transaminase (ALT) at all three follow-up visits: 2 wk (p=0.02), 6 mo (p=0.003), 12 mo (p=0.001) and an increase in aspartate aminotransferase (AST) after 6 mo (p=0.007) and 12 mo (p=0.04). Abnormal LFT levels (AST and/or ALT) were observed in 23.4% of patients after a normal baseline, with ALT increase being more common. Furthermore, homosexuality was identified as a significant independent factor associated with abnormal LFT (AOR=3.1; 95% CI 1.27-7.51; p=0.01). The findings indicate exceptionally elevated LFT levels and the occurrence of abnormal LFTs among HIV-positive patients initiating ARVs. The increase in abnormal LFTs was significantly associated with patients identifying as homosexual, where hepatitis co-infection may be a contributing factor. The limited study design and measured variables warrant further investigation.
Co-Authors A.A. Ketut Agung Cahyawan W Ady Bagus Indrianto Agung Endro Nugroho Al Razi Sena Alfi Yasmina Alfi Yasmina Anggit Dewi Rahayu Anggoro Budi Hartopo Annisa Setiyaningrum Anwar Santoso Asal Wahyuni Erlin Mulyadi Ave Olivia Rahman Bambang Irawan Chandra, Lukman Ade Christi Mambo David Dwi Putera Deva Bachtiar Dimas Pramita Nugraha Dwi Indria Anggraini Dyah Aryani Perwitasari Endang Mahati Erna Kristin Faridatun Khasanah Fatma Othman Gdara Guntur Benedict Hutadjulu Hari Agus Sanjoto Hendrik Hendrik Indwiani Astuti Iwan Dwiprahasto Iwan Dwiprahasto Iwan Dwiprahasto Johan Kurnianda Jonathan Hasian Haposan Luhur Pribadi Lukman Ade Chandra Maemonah, Maemonah Mardiah Suci Hardianti Mustofa Mustofa Nailatul Arifah Ngatidjan Ngatidjan Pompini Agustina Sitompul Pratiwi, Woro Rukmi Pratiwi, Woro Rukmi Rafika Mutia Sari Rita Suhadi Rizaldy Pinzon Rizki Amalia Gumilang Sari, Rafika Mutia Shofya Indraguna Siahaya, Presli Glovrig Sitti Rahmah Umniyati Sutarman S Syahru Agung Setiawan Teguh Triyono Togi Junice Hutadjulu Tri Asti Isnariani Tri Murti Andayani Tri Murti Andayani Trijayanti, Christiana Ully Adhie Mulyani Umi Sa'adatun Nikmah Wahyu Damayanti Yanri Wijayanti Subronto Yati Soenaro Yati Soenaro Yati Soenarto Yolanda Dyah Kartika