A prospective study on the changes of clinical values in HIV-Infected patients attending Kenyatta National Hospital Comprehensive Care Center

Abstract

Changes in serum levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamma-glutamyl transferase (G-GT), total protein (TP), albumin (ALB), total bilirubin (T. Bil), direct bilirubin (D. Bil) are assayed to monitor liver function; while those of creatinine (CRT) and urea (UR) are for kidney functions. These two organs produce hepcidin and erythropoietins, respectively that play major roles in haemopoiesis and so may be involved in HIV- associated anemia. Anemia occurs in over 70% of HIV-infected. The objective of this study was to monitor liver and kidney derangements in HIV based on CD4+ cell levels for 6 months. This was a longitudinal descriptive study conducted at Kenyatta National Hospital Comprehensive Care Centre and involved: 184 HIV seropositive and 101 HIV seronegative blood donors as a comparative group. The comparative group demonstrated significantly higher T.Bil and D.Bil mean values in males than in females. Increases in each of: G-GT, T. Bil, D. Bil, AST, ALT and CRT above the upper limit of the control were observed. Increases in G-GT were highest in CD4+ above 200 cells /mm3; decreases in the levels of ALP and ALB were lowest in CD4+ < 200 cells / mm3 group. Increases in G-GT with decreases in ALP were possibly due to cardiac-related disorders. Serum levels of AST, ALT and CRT are not affected by CD4+ levels. Decreases in the levels of ALB in CD4+ < 200 cells/mm3 group were thought to be partly due to: anemia, malnutrition or hypercatabolism. Hypoalbuminemia may result in altered albumin: globulin ratio. Determinations of: albumin: globulin ratio, gender-based reference ranges for T. Bil and D. Bil, hepcidin and erythropoietin are recommended.    Key words: Study, clinical values, HIV infection.