Mild Liver Enzymes Increase a Risk for HIV Sufferers

Even moderate elevations related to greater death risk, researcher says

MONDAY, July 8, 2002 (HealthDayNews) -- Doctors shouldn't ignore mild to moderate elevations in two liver enzymes in people with HIV because those increases are related to a greater risk of death, says a study from the University of Pittsburgh.

People who have mild to moderate increases of the enzymes alanine transamine (ALT) and aspartamine transamine (AST) have a death rate 1.73 times greater than people with mid-range normal levels of the enzymes, the study says.

The study, which analyzed data from 5,700 people, was presented today at the XIV International AIDS Conference in Barcelona, Spain.

"Up to a third of HIV patients have mild to moderate elevations in ALT and AST, yet physicians largely disregard the readings unless they are two to four times above the normal range," says a statement from researcher Dr. Amy Justice, an associate professor at the University of Pittsburgh Graduate School of Public Health and the University of Pittsburgh School of Medicine.

"Our study shows that even patients whose elevations are mild to moderate have a death rate that is nearly twice that of patients with mid-range normal levels. This association with increased mortality suggests than any elevation in ALT and AST should be addressed," the statement adds.

Liver failure is the most common cause of death in people who have AIDS.

Justice says elevations of the ALT and AST enzymes indicate liver cell damage and possibly injury to other cells in the body. The elevations can be caused by highly active anti-retroviral therapy (HAART), viral hepatitis or alcohol abuse.

Testing for ALT and AST is part of the routine monitoring of people with HIV. However, doctors usually only act when the levels are twice the normal level. Treatment for increased ALT and AST levels includes stopping or changing antiretroviral medications and counseling people to stop drinking alcohol.

More information

For more on the disease, try the Centers for Disease Control and Prevention or the National Institute of Allergy and Infectious Diseases.

SOURCE: University of Pittsburgh news release, July 8, 2002
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