Effect of Antiretroviral Drugs on Liver Biochemical Parameters of HIV/AIDS-Infected Pregnant Women in Enugu Metropolis, Nigeria: A Cross-Sectional Study

Background and Objective: Certain liver diseases are uniquely associated with pregnancy, whereas others are unrelated. Highly Active Antiretroviral Therapy (HAART)-associated hepatic toxicity is of increasing concern in the management of patients with HIV/AIDS. There is no available data on whether the pregnancy is associated with an increased risk of liver damage and chronic liver damage in HIV-positive women on HAART. We evaluated the effects of antiretroviral drugs on the liver biochemical parameters in HIV-infected pregnant women. Methods: Using a cross-sectional survey design, 171 women were exclusively screened for hepatitis B and hepatitis C infections; grouped as 50 HIV seronegative pregnant women, 20 newly diagnosed HIV-infected pregnant women (treatment-naive), 51 HIV-infected pregnant women already on HAART, 12 non-pregnant infected females (treatment-naive) and 38 non-pregnant HIV-infected women on HAART. Liver biomarkers were determined using standard methods. Student's t-test and one-way analysis of variance (ANOVA) followed by Tukey's Post-HOC multiple comparison tests were used to analyse the results. Results: The Aspartate Transaminase (AST), Alanine Transaminase (ALT), Alkaline Phosphatase (ALP) and Total Bilirubin (TB) levels in HIV-infected pregnant women on HAART were elevated. The AST (29.40 +/- 4.35 U/L) of naive HIV-infected pregnant women was significantly low (p<0.05) compared to non-pregnant naive HIV-infected women with AST (53.36 +/- 5.92 U/L). Also, the ALP (272.5 +/- 22.79 U/L) and TP (80.9 +/- 4.40 g/L) of naive HIV-infected pregnant women were highly significant (p<0.05) compared to non-pregnant naive HIV-infected women with ALP and TP levels of (200.30 +/- 12.74 U/L) and (63.70 +/- 6.50) g/L respectively. On the basis of the trimester, HIVpositive pregnant women on HAART had significantly higher levels of liver markers when compared with that of HIVsero-negative pregnant women. Interpretation and Conclusion: Pregnancy is associated with an increased risk of liver damage and chronic liver damage in HIV-positive women on HAART.