Page 107 - Malaysian Journal of Health Promotion, Vol 4 (Supplementary 1) 2022

Malaysian Journal of Health Promotion, Vol 4 (Supplementary 1) 2022
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14 MOH-AMM Scientific Meeting 2022 in conjunction with 23 NIH Scientific Conference Abstract Book
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cognitive, affective, and behavioural domains (CAB). This presentation describes the socio-
demographic characteristics of survey respondents.
METHODS: The NHMS 2020 utilised a cross-sectional design. Main criteria are individual over
the age of 13. Postal survey was utilised because of the movement control order following
COVID-19 pandemic. The sample size was determined using a proportional formula. The
validated self-administered questionnaire was available in English and Bahasa Melayu. The
survey was conducted between August - October 2020.
RESULTS: Overall, 5,564 respondents were eligible with a response rate of 73.56% (4,588). By
region, 71.1% were from Peninsular Malaysia, Sabah (12.8%), and Sarawak (16.2%). Malay
ethnics reporting the highest proportion of respondents (65.6%). High percentages were
observed in younger adults aged 20 to 29 (19.5%) and 30 to 39 (19.1%). 44.0% of respondents
had a secondary education, followed by 27.6% with a postsecondary education, and 15.0%
with a primary education.
DISCUSSION/CONCLUSION: Socio-demographic results show that the survey was well-
attended, with a proportionally by various socio-demographic indicators. A well-planned
strategy is important for implementing a national survey.

ID 120 INCIDENCE OF LIVER INJURY IN PATIENTS INITIATED WITH ANTIRETROVIRAL
THERAPY

Kausalya Nawaratnam, Tay Siow Chia, Sumayyah Shafifi A Karim, Nur Khalidah binti Mohd Musa
Department of Pharmacy, Cheras Health Clinic, Federal Territory of Kuala Lumpur & Putrajaya Health
Department, Ministry of Health Malaysia

INTRODUCTION: Liver injury occurs with antiretroviral therapy (ART) and are contributed by
HIV infection, hepatitis viruses’ coinfection, or concomitant prophylaxis therapy. This study
aims to assess the incidence of liver injury on ART and to identify contributing risk factors.
METHODS: A retrospective cohort study was conducted involving 362 HIV positive, normal
liver function patients initiated with first-line ART in health clinics in Kuala Lumpur and
Putrajaya from May 2017 to December 2019. Alanine aminotransferase (ALT) measurements
were recorded at baseline and followed up monthly up to 12 months. The association of liver
injury with ART regimen, concomitant Pneumocystis carinii pneumonia (PCP) prophylaxis and
isoniazid prophylaxis therapy (IPT) was studied using Chi-square and Fisher’s exact tests. Cox-
regression analysis was used to study other risk factors involved.
RESULTS: The incidence of liver injury upon ART initiation was 34 cases/100 person-year while
2 cases/100 person-year developed severe liver injury. Increasing trend of mild and moderate
liver injury was observed over the first three months of ART exposure. Liver injury risk was
higher in Tenofovir/Emtricitabine regimen compared to Lamivudine/Zidovudine (p=0.035,
OR=2.174). No significant difference was found between subjects using Efavirenz and
Nevirapine. Concomitant PCP prophylaxis demonstrated significantly lower risk of liver injury
(p=0.006, OR=0.483) while concomitant IPT contributed to higher risk (p=0.019, OR=1.793).
DISCUSSION/CONCLUSION: This study highlighted the importance of monthly liver enzymes
monitoring for the first three months of ART initiation. Subjects with tenofovir/emtricitabine,
concomitant isoniazid therapy and without PCP prophylaxis were the high-risk groups that
required close monitoring of the liver enzymes.

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