Publication:
Prevalence and Incidence of Liver Dysfunction and Assessment of Biomarkers of Liver Disease in HIV-Infected Asian Children

Issued Date

2015-06-22

Resource Type

Article

ISSN

15320987
08913668

DOI

10.1097/INF.0000000000000693

Other identifier(s)

2-s2.0-84937719975

Rights

Mahidol University

Rights Holder(s)

SCOPUS

Bibliographic Citation

Pediatric Infectious Disease Journal. Vol.34, No.6 (2015), e153-e158

Suggested Citation

Linda Aurpibul, Torsak Bunupuradah, Sam Sophan, David Boettiger, Dewi K. Wati, Lam V. Nguyen, Vonthanak Saphonn, Rawiwan Hansudewechakul, Kulkanya Chokephaibulkit, Pagakrong Lumbiganon, Khanh H. Truong, Viet C. Do, Nagalingeswaran Kumarasamy, Nik K.N. Yusoff, Kamarul Razali, Nia Kurniati, Siew M. Fong, Revathy Nallusamy, Annette H. Sohn Prevalence and Incidence of Liver Dysfunction and Assessment of Biomarkers of Liver Disease in HIV-Infected Asian Children. Pediatric Infectious Disease Journal. Vol.34, No.6 (2015), e153-e158. doi:10.1097/INF.0000000000000693 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/36403

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Title

Prevalence and Incidence of Liver Dysfunction and Assessment of Biomarkers of Liver Disease in HIV-Infected Asian Children

Author(s)

Linda Aurpibul
 Torsak Bunupuradah
 Sam Sophan
 David Boettiger
 Dewi K. Wati
 Lam V. Nguyen
 Vonthanak Saphonn
 Rawiwan Hansudewechakul
 Kulkanya Chokephaibulkit
 Pagakrong Lumbiganon
 Khanh H. Truong
 Viet C. Do
 Nagalingeswaran Kumarasamy
 Nik K.N. Yusoff
 Kamarul Razali
 Nia Kurniati
 Siew M. Fong
 Revathy Nallusamy
 Annette H. Sohn

Other Contributor(s)

Chiang Mai University
 The HIV Netherlands Australia Thailand Research Collaboration
 National Pediatric Hospital
 University of New South Wales (UNSW) Australia
 Universitas Udayana
 National Hospital of Pediatrics Hanoi
 National Center for HIV/AIDS
 University of Health Sciences
 Chiangrai Prachanukroh Hospital
 Mahidol University
 Khon Kaen University
 Children's Hospital 1
 Children's Hospital 2
 YR Gaitonde Centre for AIDS Research and Education
 Hospital Raja Perempuan Zainab II
 Kuala Lumpur Hospital
 University of Indonesia, RSUPN Dr. Cipto Mangunkusumo
 Hospital Likas
 Penang Hospital
 Foundation for AIDS Research

Abstract

© 2015 Wolters Kluwer Health, Inc. All rights reserved. Background: We determined the prevalence and incidence of liver dysfunction before and after initiation of combination antiretroviral therapy (cART) in the TREAT Asia Pediatric HIV Observational Database. Methods: Data from children initiated on cART between 2 and 18 years of age with baseline alanine aminotransferase (ALT) available before and at least once after cART initiation in TREAT Asia Pediatric HIV Observational Database between 2008 and 2012 were analyzed. Prevalence and incidence of liver dysfunction and biomarkers including the aspartate aminotransferase to platelet ratio index and FIB4 index (a noninvasive panel to stage liver disease) were assessed. Results: Data from 1930 children were included. Their median age was 6.9 years; 49% were male; 98% were perinatally infected and 94% were initiated on non-nucleoside reverse transcriptase-based cART regimens. Before cART, the prevalence of ALT ≥3 times the upper limit of normal (×ULN) was 5.8%. There were 8.5% of children with aspartate aminotransferase to platelet ratio index >1.5 (suggestive of liver fibrosis) and 2.7% with FIB4 index >1.3 (predictive of possible cirrhosis). Among the 1143 cases with normal baseline ALT (≤1×ULN), the incidence of ALT 3×ULN after cART was 1.19 of 1000 person-months (95% confidence interval: 0.93-1.51). Two of 350 with available tests (0.6%) met Hy's law (ALT >3×ULN and total bilirubin >2×ULN). By multivariate analysis, baseline hemoglobin <7.5 g/dL was a predictor of ALT >3×ULN, whereas age 5-9 years at cART initiation was protective for liver dysfunction. Conclusions: We demonstrated a low prevalence and incidence of liver dysfunction before and after cART initiation in children with normal baseline chemistries. In this population facing life-long cART, prospective surveillance for emergence of liver disease is warranted.

Keyword(s)

Medicine

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URI

https://repository.li.mahidol.ac.th/handle/20.500.14594/36403

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Scopus 2011-2015