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Original research article


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 GitauSudhir VinayakMicah SilabaRodney AdamReena 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.
Corresponding Author:
Corresponding Author

Samuel Nguku Gitau

Department of Radiology and Imaging, Aga Khan University Hospital, Nairobi, P.O. Box 30270-00100, Nairobi, Kenya.
E-mail: samuelnguku12@gmail.com

Corresponding Author:
Corresponding Author

Samuel Nguku Gitau

Department of Radiology and Imaging, Aga Khan University Hospital, Nairobi, P.O. Box 30270-00100, Nairobi, Kenya.
E-mail: samuelnguku12@gmail.com

DOI: 10.4103/2156-7514.183582 Facebook Twitter Google Linkedin

ABSTRACT



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

  1. 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
  2. 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 Medicine 2017:1. doi: 10.1155/2017/5629130
  3. 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

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