{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T12:32:14Z","timestamp":1790253134729,"version":"4.1.0"},"reference-count":38,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2019,1,1]],"date-time":"2019-01-01T00:00:00Z","timestamp":1546300800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000098","name":"NIH Clinical Center","doi-asserted-by":"publisher","award":["D43 TW009775"],"award-info":[{"award-number":["D43 TW009775"]}],"id":[{"id":"10.13039\/100000098","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Int Assoc Provid AIDS Care"],"published-print":{"date-parts":[[2019,1,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Serum alanine aminotransferase (ALT) elevations are common among HIV-infected patients on combination antiretroviral therapy (cART).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Approach:<\/jats:title>\n                    <jats:p>We conducted a prospective cohort study of 3023 HIV-infected Tanzanian adults initiating cART. We assessed risk factors for mild\/moderate ALT elevations &gt;40 IU\/L and severe ALT elevations &gt;200 IU\/L.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>We found that over a median follow-up of 32.5 months (interquartile range: 19.4-41.5), 44.8% of participants had at least 1 incident ALT elevation &gt;40 IU\/L of which 50.1% were persistent elevations. Risk factors for incident ALT elevation &gt;40 IU\/L included male sex, CD4 count &lt;100 cells\/\u03bcL, d4T+3TC+NVP cART, and triglycerides \u2265150 mg\/dL ( P values &lt;.05). Hepatitis B coinfection and alcohol consumption increased the risk of severe ALT elevations &gt;200 IU\/L ( P values: &lt;.05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Incident mild and moderate ALT elevations are common among Tanzanians initiating cART, and the clinical and demographic information can identify patients at increased risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/2325958219884939","type":"journal-article","created":{"date-parts":[[2019,10,31]],"date-time":"2019-10-31T05:00:11Z","timestamp":1572498011000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["Risk Factors for Alanine Aminotransferase Elevations in a Prospective Cohort of HIV-Infected Tanzanian Adults Initiating Antiretroviral Therapy"],"prefix":"10.1177","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3367-0564","authenticated-orcid":false,"given":"Sabina F.","family":"Mugusi","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacology, School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania"},{"name":"Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Sando","sequence":"additional","affiliation":[{"name":"Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ferdinand M.","family":"Mugusi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Hawkins","sequence":"additional","affiliation":[{"name":"Center for Global Health, Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Said","family":"Aboud","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wafaie W.","family":"Fawzi","sequence":"additional","affiliation":[{"name":"Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher R.","family":"Sudfeld","sequence":"additional","affiliation":[{"name":"Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2019,10,31]]},"reference":[{"key":"bibr1-2325958219884939","doi-asserted-by":"publisher","DOI":"10.1093\/clinchem\/46.12.2050"},{"key":"bibr2-2325958219884939","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1991.00400020036008"},{"key":"bibr3-2325958219884939","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2003.07486.x"},{"key":"bibr4-2325958219884939","doi-asserted-by":"publisher","DOI":"10.1111\/j.1478-3231.2006.01197.x"},{"key":"bibr5-2325958219884939","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa012035"},{"key":"bibr6-2325958219884939","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e318198a88a"},{"key":"bibr7-2325958219884939","doi-asserted-by":"publisher","DOI":"10.1086\/381499"},{"key":"bibr8-2325958219884939","doi-asserted-by":"publisher","DOI":"10.1097\/COH.0b013e328122dbaa"},{"key":"bibr9-2325958219884939","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgast-2017-000166"},{"issue":"6","key":"bibr10-2325958219884939","first-page":"430","volume":"2","author":"Neff GW","year":"2006","journal-title":"Gastroenterol Hepatol (NY)"},{"key":"bibr11-2325958219884939","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2005.11.027"},{"key":"bibr12-2325958219884939","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(99)80020-8"},{"key":"bibr13-2325958219884939","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-200107060-00007"},{"key":"bibr14-2325958219884939","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(98)80341-3"},{"key":"bibr15-2325958219884939","doi-asserted-by":"publisher","DOI":"10.1086\/518655"},{"key":"bibr16-2325958219884939","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.13083"},{"key":"bibr17-2325958219884939","doi-asserted-by":"publisher","DOI":"10.1124\/jpet.106.112136"},{"key":"bibr18-2325958219884939","unstructured":"World Health Organization. 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