US researchers have
found that liver function tests significantly
predicted survival independently of CD4 count and
viral load. In a collaboration of research from two different
cohorts at seven US sites presented today at the Fourteenth International AIDS Conference in Barcelona, statistical analysis of
the CHORUS database of nearly 6000 persons and the VACS 3
database of almost 900 found that measurements of
aspartate aminotransferase (AST) and alanine
aminotransferase (ALT) of twice the upper limit were
strongly associated with decreased survival, and
even mild to moderate elevations of liver fuction
tests were associated with poorer outcome, independent of hepatitis C infection (a common cause of liver enzyme elevation).
Since elevated liver tests can be caused by a variety
of factors, including alcohol use, viral hepatitis and
HAART itself, and are common amongst those with HIV
infection, the researchers conclude that management of
elevated liver enzymes deserves more clinical attention.
References
Justice AC et al. HIV survival: liver function tests independently predict survival. XIV International AIDS Conference, Barcelona, abstract MoOrB1058, 2002.