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Jackson Foundation","doi-asserted-by":"publisher","award":["W81XWH\u201011\u20102\u20100174"],"award-info":[{"award-number":["W81XWH\u201011\u20102\u20100174"]}],"id":[{"id":"10.13039\/100003896","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000005","name":"U.S. Department of Defense","doi-asserted-by":"publisher","award":["W81XWH\u201018\u20102\u20100040"],"award-info":[{"award-number":["W81XWH\u201018\u20102\u20100040"]}],"id":[{"id":"10.13039\/100000005","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Intern AIDS Soc"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Liver disease is a common cause of non\u2010AIDS morbidity and mortality in people living with HIV (PLHIV), but the prevalence and significance of liver function test (LFT) abnormalities in early HIV infection is unknown. This study aimed to characterize LFTs in a large cohort of participants with acute HIV infection initiating immediate antiretroviral therapy (ART) and examine the association between LFTs and biomarkers of HIV infection and inflammation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We measured LFTs at the time of HIV diagnosis and at 4, 12, 24 and 48\u00a0weeks after ART initiation in 426 Thai individuals with acute HIV infection from 2009 to 2018. A subset of individuals had data available at 96 and 144\u00a0weeks. We excluded individuals with concomitant viral hepatitis. Alanine aminotransferase (ALT) was the primary outcome of interest; values greater than 1.25 times the upper limit of normal were considered elevated. Analyses utilized descriptive statistics, non\u2010parametric tests and multivariate logistic regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixty\u2010six of the 426 individuals (15.5%) had abnormal baseline ALT levels; the majority (43\/66, 65.5%) had Grade 1 elevations. Elevated baseline ALT correlated with Fiebig stages III to V (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.001) and baseline HIV RNA &gt;6 log<jats:sub>10<\/jats:sub> copies\/mL (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.012). Baseline elevations resolved by 48\u00a0weeks on ART in 59 of the 66 individuals (89%). ALT elevations at 24 and 48\u00a0weeks correlated with Fiebig stages I to II at diagnosis (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001), baseline plasma HIV RNA levels &lt;6 log<jats:sub>10<\/jats:sub> copies\/mL (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001), abnormal baseline ALT (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001), baseline CD4 &gt;350 cells\/\u03bcL (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.03) and older age (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.03). Individuals initiating efavirenz\u2010based regimens were more likely to have elevated ALT levels at 48\u00a0weeks compared with those on non\u2010efavirenz\u2010based regimens (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.003).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>One in six people with acute HIV infection have elevated LFTs. Clinical outcomes with ART started in acute HIV are generally good, with resolution of ALT elevations within 48\u00a0weeks on ART in most cases. These results suggest a multifactorial model for hepatic injury involving a combination of HIV\u2010associated and ART\u2010associated processes, which may change over time.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.25444","type":"journal-article","created":{"date-parts":[[2020,1,18]],"date-time":"2020-01-18T04:10:25Z","timestamp":1579320625000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Liver function test abnormalities in a longitudinal cohort of Thai individuals treated since acute HIV infection"],"prefix":"10.1002","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0585-6230","authenticated-orcid":false,"given":"Michael J","family":"Peluso","sequence":"first","affiliation":[{"name":"Division of HIV, Infectious Diseases, and Global Medicine University of California San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3931-5926","authenticated-orcid":false,"given":"Donn J","family":"Colby","sequence":"additional","affiliation":[{"name":"SEARCH Thai Red Cross AIDS Research Centre Bangkok Thailand"},{"name":"U.S. Military HIV Research Program Walter Reed Army Institute of Research Silver Spring MD USA"},{"name":"Henry M. Jackson Foundation for the Advancement of Military Medicine Bethesda MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suteeraporn","family":"Pinyakorn","sequence":"additional","affiliation":[{"name":"U.S. Military HIV Research Program Walter Reed Army Institute of Research Silver Spring MD USA"},{"name":"Henry M. Jackson Foundation for the Advancement of Military Medicine Bethesda MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sasiwimol","family":"Ubolyam","sequence":"additional","affiliation":[{"name":"HIV\u2010NAT Thai Red Cross AIDS Research Centre Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jintana","family":"Intasan","sequence":"additional","affiliation":[{"name":"SEARCH Thai Red Cross AIDS Research Centre Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rapee","family":"Trichavaroj","sequence":"additional","affiliation":[{"name":"Armed Forces Research Institute of Medical Sciences Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nitiya","family":"Chomchey","sequence":"additional","affiliation":[{"name":"SEARCH Thai Red Cross AIDS Research Centre Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peeriya","family":"Prueksakaew","sequence":"additional","affiliation":[{"name":"SEARCH Thai Red Cross AIDS Research Centre Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bonnie M","family":"Slike","sequence":"additional","affiliation":[{"name":"U.S. Military HIV Research Program Walter Reed Army Institute of Research Silver Spring MD USA"},{"name":"Henry M. Jackson Foundation for the Advancement of Military Medicine Bethesda MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shelly J","family":"Krebs","sequence":"additional","affiliation":[{"name":"U.S. Military HIV Research Program Walter Reed Army Institute of Research Silver Spring MD USA"},{"name":"Henry M. Jackson Foundation for the Advancement of Military Medicine Bethesda MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ningbo","family":"Jian","sequence":"additional","affiliation":[{"name":"U.S. Military HIV Research Program Walter Reed Army Institute of Research Silver Spring MD USA"},{"name":"Henry M. Jackson Foundation for the Advancement of Military Medicine Bethesda MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merlin L","family":"Robb","sequence":"additional","affiliation":[{"name":"U.S. Military HIV Research Program Walter Reed Army Institute of Research Silver Spring MD USA"},{"name":"Henry M. 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