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Assessment of selected liver enzyme activity in patients with rifampicin-resistant tuberculosis receiving treatment at a tertiary healthcare facility, southwest Nigeria

*1Olaniyan, O. A, 2Olowookere, A. K., 3Adelakun, A. A., 4Olaniyi, J. O., 5Zakariyau, T. O., 2Adeniji, T. W., 2Olaniyan, A. M., 2Oguntola, A. M., and 2Taiwo, S. S.
Departments of 1Chemical Pathology, 2Medical Microbiology, and

5Haematology/Blood Transfusion, LAUTECH Teaching Hospital, Ogbomoso, Nigeria

3Department of Medical Laboratory Science, Babcock University, Ilishan-Remo, Ogun State, Nigeria

4TB DOTS Clinic, LAUTECH Teaching Hospital, Ogbomoso, Nigeria *Correspondence to:peace_amazinggrace@yahoo.co.uk

Abstract:

Background: Several anti-tuberculous drugs have been effective in the treatment and management of drug- sensitive and -resistant tuberculosis (TB). While these drug combinations have proven to be highly active against tubercle bacilli, side effects and toxicity may occur with tendency to interrupt or discontinue therapy, resulting in poor compliance. The objective of this study is to assess hepatotoxic potentials of anti-TB drugs among patients with rifampicin-resistant TB (RRTB) undergoing treatment at the directly observed treatment short-course (DOTS) clinic of Ladoke Akintola University of Technology (LAUTECH) Teaching Hospital, Ogbomoso, Nigeria.

Methodology: This was a prospective study of 40 patients with RRTB on second-line anti-TB therapy including bedaquiline, moxifloxacin, prothionamide, ethambutol, pyrazinamide, isoniazid and clofazimine. RRTB was diagnosed by sputum smear AFB microscopy and Xpert MTB/RIF assay at the TB laboratory of Bowen University Teaching Hospital, Ogbomoso, Nigeria. Forty gender and age-matched apparently healthy persons were used as control. Venous samples (~5ml) were collected from each participant at baseline (prior to commencement of anti-TB therapy) and after completion of 9-11 months therapy, as well as from the controls. Plasma was separated by centrifugation and the activity of ALT, AST and ALP was measured by spectrophotometric analysis, while total protein and albumin levels were determined using routine methods. Data were presented as mean±SD and analysed using SPSS version 21.0. Comparison of the mean enzyme activity at baseline and after completion of therapy as well as with the control was done with unpaired ‘t’ test, and ‘p’ (two tail) value less than 0.05 was considered statistically significant. Continue reading “Assessment of selected liver enzyme activity in patients with rifampicin-resistant tuberculosis receiving treatment at a tertiary healthcare facility, southwest Nigeria”

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Histological and biochemical markers of the liver of male Wistar rats on oral administration of nevirapine suspension

EK Oladipo, AY Afolabi, IO Omomowo, JK Oloke, EH Awoyelu

 

Abstract

Background: Mechanism of action of nevirapine in the prophylaxis treatment and treatment of HIV-1 may involve elevations in levels of alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase and other biomarkers of liver function. This study presents the hepatotoxic effect of nevirapine suspension using animal model.

Methods: A total number of 15 male Wister rats were fed normal chow and antiretroviral drug (Nevirapine) for a period of six weeks. The liver organ of the rats were obtained and subjected to histological procedures and biochemical analysis using enzyme assay obtained from Randox Laboratories Limited, Antrim United Kingdom (BT294QY).

Results: The wistar rats showed no significant mean body weight difference when compared with the control group. However there was significant difference in the mean values of AST (77.77±3.03) and ALT (89.37±3.19) of the treated rats. Nevirapine treated rats showed significant difference in AST, ALT, and ALP in the single (77.77± 3.03, 31.80±1.73, 43.81 ±1.54) and double (89.37±3.19, 33.38±2.01, 34.64 ±1.02) doses when compared with the controls (75.14 ±2.00, 29.16±0.17, 45.44 ±1.85) respectively. Mild vascular congestion, infiltration of sinusoids by inflammatory cells, and haemorrhage were induced by nevirapine as compared with the control group showing normal vessels without congestion, normal sinusoids appearing normal without infiltration.

Conclusion: The liver histology of the rats fed with Nevirapine suspension showed diffused hepatocellular necrosis. Routine check of the drug effect is important as it provides effective life management of HIV infected individuals.

Keywords: Nevirapine, Wister rat, Hepatotoxicity, Liver, Alanine aminotransferase (ALT), Aspartate aminotransferase (AST), Alkaline phosphatase (ALP)

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Histological and biochemical markers of the liver of male Wistar rats on oral administration of nevirapine suspension

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The effects of antiretroviral treatment on liver function enzymes among HIV-infected out patients attending the Central Hospital of Yaounde, Cameroon

K Lucien, A Clement, N Fon, P Weledji, C Ndikvu

 

Abstract

The emergence of liver diseases as one of the major causes of death in people infected with HIV has paralleled the introduction of more effective antiretroviral therapies. This study was carried out with the aim of determining the effects of antiretroviral treatment on liver enzymes (SGOT and SGPT) in patients placed on antiretroviral therapy. A prospective cross-sectional 3 years study was carried out among patients confirmed to be HIV positive and who were to be placed on antiretroviral drugs at the HIV/AIDS out patient clinic of the Yaoundé Central Hospital, . Cameroon. Levels of transaminases of patients were measured in four phases using the International Federation of Clinical Chemistry (IFCC) protocol. Of the 150 patients who participated in the study, 54.0 %( 81/150) presented with transaminitis at the final phase of the study with respect to aspartate aminotransferase (AST), 77.78% (63/81) of whose AST levels only increased after initiation of highly active antiretroviral therapy (HAART). 22.67% (34/150) presented with transaminitis with respect to alanine aminotransferase (ALT). At the final phase, 70.58% of whose ALT levels only increased after HAART initiation. Increase in blood transaminase levels was statistically independent on age group and the drug combinations. Increase in AST levels was associated with an increase in ALT levels upon treatment (r = 0.58). There was a significant positive linear relationship between duration of treatment and concentration of transaminases over the years (r= 0.9). We therefore concluded that highly active antiretroviral therapy (HAART) is associated with low level hepatotoxicity at therapy initiation, regardless of drug class or combination.

Keywords: Antiretroviral treatment, Liver function enzymes, Hepatotoxicity, Highly active antiretroviral therapy

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The effects of antiretroviral treatment on liver function enzymes among HIV-infected out patients attending the Central Hospital of Yaounde, Cameroon