Prevalence of Liver Damage in Patients Under Antiretroviral Therapy at Gitwe District Hospital

Background: The emergence of liver diseases as one of the major causes of death in people infected with HIV has paralleled the introduction of more effective antiretroviral therapies. More than 60% of the prescribed drugs are cleared in the liver, and hepatic injury is the most frequent cause of drug discontinuation in clinical trials. Thus, it is not surprising that all ART drugs have some risk of hepatotoxicity, which varies depending on the specific characteristics of the drugs. Measuring liver enzymes is the most common way of determining hepatotoxicity. HIV and antiretroviral medications both cause abnormalities in liver enzymes. Antiretroviral (ARV) medications harm liver cells either directly or through their active metabolites Objective: The aim of this study was to determine the prevalence of liver damage in patients exposed to antiretroviral therapy at Gitwe District Hospital. Materials and methods: Retrospective study was conducted in 212 HIV patients attending GITWE District Hospital, Southern province, Rwanda from 2023-2024. Patients under HAART with valid liver function test results for alanine aminotransferase (ALT), aspartate aminotransferase (AST) were included. Results: Among 212 patients included in the study, from 2023 to 2024, 24(11.32%) presented mild, moderate, and severe liver damage. Very few severe cases 4(1.9%) were observed, Normal female and male represented high percentage among the patients: 116(54.5%) and 72(34.0%) respectively. Conclusions: Mild and moderate liver damage were present in HIV patients; Severe liver damage were rare 4(1.9%) in all patients but many of the patients showed normal liver function. The effort made by health care providers in regular monitoring of hepatotoxicity among HIV-infected patients and advising patient to moderate alcohol consumption must be supported in order to avoid severe liver damage and other health complications. Keywords: HIV, antiretroviral Therapy, liver enzyme elevation, Prevalence