Hepatic histomorphological changes following highly active antiretroviral therapy and the intervention of hypoxis hemerocallidea in an experimental animal model.
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Date
2015
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Abstract
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.
Description
Master of Medical Sciences in Anatomy. University of KwaZulu-Natal, Medical School 2015.
Keywords
Morphology (Animals), Liver -- Histology., Highly active antiretroviral therapy., Toxic hepatitis., Theses -- Clinical anatomy.