Elevated alanine aminotransferase (ALT) levels in Human Immunodeficiency Virus\n(HIV) infected people is a major concern in the world and especially in Africa. It\nmay lead to liver failure and even death. Certain antiretroviral (ARV) drugs, such as\nnevirapine and efavirenz, are known to cause toxicity. Other causes of elevated ALT\nare viral hepatitis, the HIV virus itself and other drugs such as anti-tu- berculosis\ndrugs and alcoholism. The study aimed at determining the prevalence of elevated\nALT levels in HIV positive patients on antiretroviral therapy during the period 2013\nto 2014. This was a retrospective study which included 267 patient records from\nKatutura and Windhoek Central hospitals in Windhoek, Namibia. The subjects� ages\nranged from 21 to 82 years. The patients enrolled were on the first line treatment and\ntheir ALT levels were recorded at each monitoring period. ALT levels, viral hepatitis\nresults and the antiretroviral therapy (ART) regimen were the most important aspects\nincluded in the study. Out of 267 patients, 18% had ALT elevation associated\nwith grade 1 to 4 toxicity levels. The study found that 1.4% of patients developed severe\nliver toxicity (grade 3 and 4 toxicity). Toxicity occurred throughout the treatment\nperiod but was the highest at six months of treatment. Patients on nevirapine\nbased regimens had lower toxicity compared to those receiving efavirenz based regimens.\nPatients who had HIV and viral hepatitis co-infection had high toxicity although\nthe study found no severe hepatotoxicity in these patients.
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