Lab tests can detect levels of certain proteins commonly called "liver enzymes." Two examples of these enzymes include:
ALT is made by the liver. AST is made mostly by the liver but also by several other organs/systems, in decreasing order: the heart, skeletal muscles, kidneys, brain, pancreas, lungs, white and red blood cells. Yet, AST is still commonly considered a liver enzyme.
In general, liver enzyme levels rise above normal when the liver is being damaged. In some people with HIV/AIDS (PHAs), higher-than-normal levels of liver enzymes are common, perhaps caused by hepatitis, the toxicity of anti-HIV medications and the use of alcohol and other drugs.
Researchers at the University of Pittsburg analysed information from a large database on nearly 7,000 subjects to find a link between higher-than-normal liver enzymes, a condition called transaminitis, and survival. They considered liver enzymes to be high when they were at levels twice above normal.
The researchers found that higher-than-normal levels, particularly of AST, were associated with reduced chances of survival. These high AST levels were linked to the following:
Even after researchers adjusted their calculations by taking into account subjects who had low CD4+ cell counts and high viral loads (and who were therefore at increased risk of death), having elevated AST levels was linked to reduced survival when compared to PHAs who had normal AST levels.
The researchers concluded that high liver enzyme levels have a major connection to survival. They suggest that even mildly elevated levels of liver enzymes deserve attention.
REFERENCE
Justice AC, Wagner JH, Fusco GP, et al. HIV survival: liver function tests independently predict survival. XIV International AIDS Conference, July 7-12, 2002, Barcelona. Abstract MoOrB1058.
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