High Prevalence of Liver Fibrosis in Patients with Human Immunodeficiency Virus Monoinfection and Human Immunodeficiency Virus Hepatitis-B Co-infection as Assessed by Shear Wave Elastography: Study at a Teaching Hospital in Kenya.
Samuel Nguku Gitau, Sudhir Vinayak, Micah Silaba, Rodney Adam, Reena Shah
Departments of Radiology and Imaging and Internal Medicine, Aga Khan University Hospital, Nairobi, Kenya
Date of Submission: 04-Jan-2016, Date of Acceptance: 07-Mar-2016, Date of Web Publication: 07-Jun-2016.
Objectives: The aim of this study was to determine the prevalence of liver fibrosis in patients with human immunodeficiency virus (HIV) monoinfection versus those with HIV hepatitis-B virus (HBV) co-infection as assessed with shear wave elastography (SWE) in a tertiary sub-Saharan Africa hospital. Materials and Methods: A total of 105 consecutive patients, 70 with HIV monoinfection and 35 with HIV-HBV co-infection, had liver elastography obtained using SWE to assess for the presence of liver fibrosis the cutoff of which was 5.6 kPa. Assessment of aspartate aminotransferase-to-platelet ratio index (APRI) score (a noninvasive serum biomarker of liver fibrosis) in these patients was also done. Results: The prevalence of liver fibrosis was significantly higher (P < 0.0001) in patients with HIV-HBV co-infection, 25.7%, compared to those with HIV monoinfection, 7.1%. APRI score was greater in patients with HIV-HBV co-infection than those with HIV monoinfection. HIV co-infection with HBV accelerates progression to liver fibrosis. Association of a low cluster of differentiation 4 (CD-4) count with advanced fibrosis supports earlier starting of antiretroviral therapy to prevent rapid progression of liver disease in HIV-positive patients. Conclusion: In view of the high prevalence of liver fibrosis in patients with HIV-HBV co-infection, regular monitoring of the disease progression is recommended.
Keywords: Hepatitis-B, Human Immunodeficiency Virus, Liver Fibrosis, Shear Wave Elastography
Cited in 3 Documents
Jennifer L Grant, Patricia Agaba, Placid Ugoagwu, Auwal Muazu, Jonathan Okpokwu, Samuel Akpa, Stephen Machenry, Godwin Imade, Oche Agbaji, Chloe L Thio, Robert Murphy and Claudia Hawkins (2019) Changes in liver stiffness after ART initiation in HIV-infected Nigerian adults with and without chronic HBV. :. doi: 10.1093/jac/dkz145
Semvua B. Kilonzo, Daniel W. Gunda, Flora Kashasha and Bonaventura C. Mpondo (2017) Liver Fibrosis and Hepatitis B Coinfection among ART Naïve HIV-Infected Patients at a Tertiary Level Hospital in Northwestern Tanzania: A Cross-Sectional Study. Journal of Tropical Medicine2017:1. doi: 10.1155/2017/5629130
Brenda Nherera, Kudakwashe Mhandire, Tinashe K. Nyazika, Alfred Makura, Cuthbert Musarurwa, Prichard T. Mapondera, Babill Stray-Pedersen and Hilda T. Matarira (2019) Comparison of non-invasive methods of assessing liver fibrosis in combination ART-experienced Zimbabweans. South. Afr. j. HIV med.20(1):. doi: 10.4102/sajhivmed.v20i1.844
This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-Share Alike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.