Hepatic histomorphological changes following highly active antiretroviral therapy and the intervention of hypoxis hemerocallidea in an experimental animal model.
Introduction Hepatotoxicity has remained a serious complication limiting the efficacy of highly active antiretroviral therapy (HAART) regimen. While this challenge continues to exist, finding possible solutions continues to attract scientific solutions. Materials and Method: Sixty- three adult male Sprague-Dawley rats were used for the study and were divided into 9 groups (A-I). Group A received HAART cocktail (Lamivudine, Stavudine & Nevirapine), Group B received HAART and H. hemerocallidea extract (100 mg/kgbw), Group C received HAART and H. hemerocallidea extract (200 mg/kgbw), Group D received HAART and vitamin C, Group E received HAART and vitamin E, Group F received HAART, vitamin C and vitamin E, Group G received H. hemerocallidea extract (100 mg/kgbw), Group H received H. hemerocallidea extract (200 mg/kgbw), and Group I received water as placebo. The experiment lasted for 56 days after which, the animals were sacrificed, the liver were harvested and prepared for histological examination and blood samples were collected through cardiac puncture and centrifuged to get the serum for biochemical assessment. Results While no mortality was reported, animals treated with adjuvant HAART and AP recorded least %body weight gain. Significant derangements in serum lipid profiles were exacerbated by treatment of with AP as LDL (increased p<0.03), TG (increased p<0.03) with no change in total cholesterol levels. Adjuvant AP with HAART recorded reduced LDL (p<0.05 and 0.03), increased HDL (p<0.05) and TG (p<0.05 and 0.001). Markers of liver injury assayed showed significant increase (p<0.003, 0.001) in AST in AP alone as well as HAART+ vitamins C and E groups respectively. Adjuvant HAART and AP and vitamins C and E also caused significant declines in ALT and ALP levels. Serum GGT were not markedly altered. Histopathological derangements ranged from severe hepatocellular distortions, necrosis and massive fibrosis following co-treatment of HAART with vitamins C and E as well as HAART alone. Conclusion The results warrant caution on the adjuvant use of H. hemerocallidea with HAART by PLWHAs as implications for hepatocellular injuries are suspect with untoward cardio metabolic changes. More vigilant monitoring of patients at risk of antiretroviral toxicity is necessary and may prove helpful.