DRUG-INDUCED LIVER INJURY IN HIV-INFECTED PATIENTS WITH ACTIVE TUBERCULOSIS: COMPARATIVE LABORATORY CHARACTERIZATION

Abstract

Introduction. Co-infection with human immunodeficiency virus (HIV) and tuberculosis constitutes specific diagnostic and 
therapeutic problems and creates a significant burden on the health care system. Two microorganisms Mycobacterium 
tuberculosis and human immunodeficiency virus potentiate each other, accelerating the deterioration of immunological 
functions and lead to premature death in the absence of treatment. According to numerous data, tuberculosis is the direct 
cause of death in an average of 30% of patients with human immunodeficiency virus. Tuberculosis and the human 
immunodeficiency virus have profound effects on the immune system because they are able to suppress the host's immune 
responses. 
The aim is to identify drug–induced liver lesions in a cohort of patients with human immunodeficiency virus infection and 
pulmonary tuberculosis.  
Materials and methods. A prospective study, the study included 150 patients with human immunodeficiency virus with 
and without active tuberculosis. All patients underwent physical and laboratory examination. Statistical processing was 
performed using IBM SPSS Statistics 29.0.2.0. 
Results. The patients were divided into three groups: The first group (I) included patients with HIV infection (n=31), the 
second (II) - with pulmonary tuberculosis (n=55); the third group (III) included patients with HIV tuberculosis (n=64)). In all 
groups, gender, age and laboratory indicators were assessed and their comparative analysis was carried out. At the next 
stage, the number of cases of drug-induced liver damage was assessed and their structure was presented. 
Conclusions 1. The incidence of hepatotoxicity in group III (59.3%) was higher than in group I (22.5%) and II (43.6%). 
2. ALT levels were higher in men of group III 45.0 (34.0; 66.0) compared to group I 36.0 (24. 75; 45.0) (p=0.015). 
3. In male patients of group III, ALT and AST indicators were higher compared to similar indicators in patients of group II, 
ALT(III) - 45.0 (34.0; 66.0) and ALT(II) (34.0 (17.0; 45.0), respectively, p = 0.008; AST(III) - 48.0 (33.0; 78.0) and AST(II) 36.0 
(22.0; 45.0), respectively, p=0.049).  
The hemoglobin level was lower in patients of group III 110.0 (96.0; 120.0) compared to the same indicator in patients of 
group II - 130.0 (100.0; 145) diseases.0), respectively, p = 0.022); 
4. Clinical signs such as cough, shortness of breath, and weakness were more often observed in patients of group III 
compared to groups I and II.  
5. The average age of women in group III was 40.0 (37.0; 44.5), respectively, younger compared to the age of women in 
group I (51.0 (45.0; 53.5), p = 0.034).