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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
High prevalence of liver fibrosis associated with HIV infection: A study in rural Rakai, Uganda
Antiviral Therapy, Volume 16, No. 3, Year 2011
Notification
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Description
Background: Liver disease is a leading cause of mortality among HIV-infected persons in the United States and Europe. However, data regarding the effects of HIV and antiretroviral therapy (ART) on liver disease in Africa are sparse. Methods: A total of 500 HIV-infected participants in an HIV care programme in rural Rakai, Uganda were frequency-matched by age, gender and site to 500 HIV-uninfected participants in a population cohort. All participants underwent transient elastography (FibroScan®) to quantify liver stiffness measurements (LSM) and identify participants with significant liver fibrosis, defined as LSM≥9.3 kPa (≈ Metavir F≥2). Risk factors for liver fibrosis were identified by estimating adjusted prevalence risk ratios (adjPRR) and 95% CI using modified Poisson multivariate regression. Results: The prevalence of hepatitis B coinfection in the study population was 5%. The prevalence of significant fibrosis was 17% among HIV-infected and 11% in HIV-uninfected participants (P=0.008). HIV infection was associated with a 50% increase in liver fibrosis (adjPRR 1.5, 95% CI 1.1-2.1; P=0.010). Fibrosis was also associated with male gender (adjPRR 1.4, 95% CI 1.0-1.9; P=0.045), herbal medicine use (adjPRR 2.0, 95% CI 1.2-3.3; P=0.005), heavy alcohol consumption (adjPRR 2.3, 95% CI 1.3-3.9; P=0.005), occupational fishing (adjPRR 2.5, 95% CI 1.2-5.3; P=0.019) and chronic HBV infection (adjPRR 1.7, 95% CI 1.0-3.1; P=0.058). Among HIV-infected participants, ART reduced fibrosis risk (adjPRR 0.6, 95% CI 0.4-1.0; P=0.030). Conclusions: The burden of liver fibrosis among HIV-infected rural Ugandans is high. These data suggest that liver disease may represent a significant cause of HIV-related morbidity and mortality in Africa. ©2011 International Medical Press.
Authors & Co-Authors
Stabinski, Lara
United States, Bethesda
National Institute of Allergy and Infectious Diseases Niaid
Reynolds, Steven James
United States, Bethesda
National Institute of Allergy and Infectious Diseases Niaid
United States, Baltimore
Johns Hopkins University
Ocama, Ponsiano
Uganda, Kampala
Makerere University
Laeyendecker, Oliver B.
United States, Bethesda
National Institute of Allergy and Infectious Diseases Niaid
Ndyanabo, Anthony
Uganda, Kalisizo
Rakai Health Sciences Program
Kiggundu, Valerian L.
Uganda, Kalisizo
Rakai Health Sciences Program
Boaz, Iga
United States, Bethesda
National Institute of Allergy and Infectious Diseases Niaid
Uganda, Kalisizo
Rakai Health Sciences Program
Gray, Ronald H.
Uganda, Kalisizo
Rakai Health Sciences Program
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Wawer, Maria J.
Uganda, Kalisizo
Rakai Health Sciences Program
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Thio, Chloe Lynne
United States, Baltimore
Johns Hopkins University
Thomas, David L.
United States, Baltimore
Johns Hopkins University
Quinn, Thomas Charles
United States, Bethesda
National Institute of Allergy and Infectious Diseases Niaid
United States, Baltimore
Johns Hopkins University
Kirk, Gregory D.
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Statistics
Citations: 79
Authors: 13
Affiliations: 5
Identifiers
Doi:
10.3851/IMP1783
ISSN:
13596535
Research Areas
Health System And Policy
Infectious Diseases
Substance Abuse
Study Design
Cross Sectional Study
Cohort Study
Study Locations
Uganda
Participants Gender
Male