Changes in liver stiffness after ART initiation in HIV-infected Nigerian adults with and without chronic HBV
| Autor: | Stephen Machenry, Oche Agbaji, Samuel Akpa, Patricia A. Agaba, Godwin E. Imade, Chloe L. Thio, Jennifer Grant, Claudia Hawkins, Jonathan Okpokwu, Auwal Muazu, Placid Ugoagwu, Robert L. Murphy |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Microbiology (medical)
Adult Liver Cirrhosis Male Longitudinal study medicine.medical_specialty Cirrhosis Nigeria HIV Infections medicine.disease_cause Sensitivity and Specificity 03 medical and health sciences Liver disease 0302 clinical medicine Hepatitis B Chronic Fibrosis Internal medicine medicine Odds Ratio Humans Pharmacology (medical) 030212 general & internal medicine Risk factor Original Research Pharmacology Hepatitis B virus business.industry Coinfection virus diseases Viral Load medicine.disease CD4 Lymphocyte Count Infectious Diseases Elasticity Imaging Techniques 030211 gastroenterology & hepatology Female Transient elastography business Biomarkers |
| Popis: | Background There are limited data from sub-Saharan Africa on long-term liver fibrosis changes in HIV- and HIV/HBV-infected individuals. Objectives To assess the effects of ART on liver stiffness measurement (LSM) using transient elastography (TE) in HIV- and HIV/HBV-infected Nigerian adults and examine factors associated with fibrosis regression. Methods We included ART-naive HIV- and HIV/HBV-infected adults (≥18 years) enrolled in a prospective, longitudinal study of liver disease between July 2011 and February 2015 at Jos University Teaching Hospital HIV Care and Treatment Centre in Nigeria. Patients initiated ART and had TE at baseline and follow-up (year 3). LSM cut-offs for Metavir scores were 5.9, 7.6 and 9.4 kPa for moderate fibrosis, advanced fibrosis and cirrhosis, respectively. We used multivariable regression to identify factors associated with TE (≥1 Metavir) stage decline. Results A total of 106 HIV- and 71 HIV/HBV-infected patients [70.5% female and median age = 34 years (IQR = 29–42 years)] were studied. Baseline LSM and median LSM decline were significantly higher in HIV/HBV- versus HIV-infected patients; 41% of HIV/HBV-infected patients regressed ≥1 Metavir stage versus 17% of HIV-infected patients (P Conclusions HBV coinfection does not attenuate LSM declines in HIV-infected patients after ART initiation despite being a risk factor for more advanced liver disease prior to therapy. The inverse association between BMI and TE stage decline needs further investigation. |
| Databáze: | OpenAIRE |
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