The Effect of Artemisinin-based Combination Therapy (ACT) Antimalaria Drugs on Liver Enzymes in Pregnancy

Abstract

Aims: Artemisinin-based Combination Therapies (ACTs) are employed as first-line agents in malaria chemotherapy. This study is aimed at assessing the effects of ACTs on renal function of pregnant women. Study Design: Comparative study. Place and Duration of Study: Pregnant women aged 18 to 50 years were recruited from antenatal clinic of Obstetrics and Gynecology Department of Ekiti State Hospital, Ado Ekiti, Nigeria between 2016 and 2018 Methodology: One hundred and eighty pregnant women were grouped into three which include:  Sixty pregnant women with malaria parasite on ACT drugs (Group A), sixty pregnant women with malaria parasite not on ACT drugs (Group B), sixty pregnant women without malaria parasite (Group C/control). Plasma Aspartate Aminotransferase (AST), Alkaline Phosphatase (ALP), Alanine Transaminase (ALT) and Lactate Dehydrogenase (LDH) activities were evaluated by standard methods. The data collected were analyzed using one-way analysis of variance (ANOVA) and Student’s t test to compare the data between the test groups and control. Results: Results showed there was a significant decrease (P=.05) in Body Mass Index in the pregnant women with malaria on ACT and those that were not on ACT when compared with control (24.1± 0.32 versus (25+ 2.30 vs 27± 1.62). A significant increase (P=.05) occurred in the levels of ALP,AST, ALT and LDH  in pregnant women with malaria not on ACT drugs when compared the control (168.45±0.19, 10.0±0.27, 8.19±0.25, 4.5±0.21) versus (143.20±0.12, 8.71±0.30, 5.99±0.21, 2.08±0.19),while no significant difference occurred in the levels of ALP,AST, ALT and LDH in pregnant women with malaria on ACT when compared with control (141.60±0.78, 8.02±0.32, 6.10±0.30, 2.75+ 0.20) vs (143.20±0.12, 8.71±0.30, 5.99±0.21, 2.08±0.19). Conclusion: Normal therapeutic dose of ACT has no harmful effect on the liver in pregnancy.