Browsing by Author "Plaisy MK"

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    Diagnostic value of serological scores for the detection of liver steatosis in people with HIV in low- and middle-income countries.
    (2026-May-01) Plaisy MK; Mondoka C; Moreira R; Samala N; Borse R; Kuniholm MH; Minga A; Wandeler G; Lopez-Iñiguez A; Michael D; Ross J; Shumbusho F; Mensah E; Shamu T; Crabtree-Ramirez BE; Byakwaga H; Rupasinghe D; Murenzi G; Mureithi F; Diero L; Mivumbi JP; Nguyen DTH; Maruri F; Jaquet A; Perazzo H
    BACKGROUND: The accuracy of Fatty Liver Index (FLI) and Hepatic Steatosis Index (HSI) to predict liver steatosis in people with HIV (PWH) remains poorly studied in low- and middle-income countries (LMICs). We assessed their diagnostic performances in a multiregional cohort. METHODS: This cross-sectional analysis included PWH aged ≥40 years on antiretroviral therapy for ≥6 months at enrolment (2020-2023) in the Sentinel Research Network (SRN) of IeDEA consortium, across 12 HIV clinics in Asia-Pacific, Americas, and central, East, southern, and West Africa regions. Liver steatosis was defined based on Controlled Attenuation Parameter (CAP) ≥248 dB/m using vibration-controlled transient elastography. HSI was evaluated in the overall population, while FLI was assessed and compared to HSI in a subset of participants with available data. Model discrimination was assessed using area under the receiver operating characteristic curve (AUROC) and model calibration with calibration plots. A decision curve analysis was performed to compare their clinical utility. RESULTS: Among 2195 PWH assessed using CAP, 624 (28.4%) presented with liver steatosis. HSI showed acceptable discriminative ability (AUROC = 0.74) but poor calibration, generally overestimating the risk, except in Asia-Pacific region. FLI performed better than HSI (AUROC = 0.80, P  < 0.001), and demonstrated good calibration except in sub-Saharan Africa. Both scores showed high clinical utility, with FLI demonstrating a greater net benefit when compared with HSI. CONCLUSION: FLI demonstrated higher accuracy and clinical utility within a subgroup of regions. However, the limited performance of FLI and HSI in sub-Saharan populations highlights the need to adapt existing tools or develop new predictive models tailored to regional contexts.
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    Hepatitis B and C Prevention, Screening and Diagnostic Services at HIV Treatment Sites: International epidemiology Databases to Evaluate AIDS.
    (2026-May-05) Kuniholm MH; Murenzi G; Samala N; Yunihastuti E; Wandeler G; Kim HN; Plaisy MK; Perazzo H; Twizere C; Odhiambo F; Bopage R; Muula G; Lo Re V; Minga A; López-Iñiguez A; Nsonde DM; Kasozi C; Wati DK; Fox MP; Kirk GD; Messou E; Cesar C; Ebasone PV; Byakwaga H; Ross J; Chimbetete C; Yendewa GA; Jaquet A; Succi RCM; Maruri F; Brazier E
    BACKGROUND: Prevention, screening and diagnostic services for hepatitis B virus (HBV) and hepatitis C virus (HCV) can prevent morbidity and mortality in people receiving HIV care. However, there is limited information about the availability of HBV and HCV services at HIV clinics globally. METHODS: The International epidemiology Databases to Evaluate AIDS (IeDEA) conducted surveys of service delivery and practices at participating HIV treatment centers from seven regions. We used 2023 survey data to measure availability of HBV vaccination, HBV and HCV screening, HBV surface antigen (HBsAg), HBV DNA, HCV antibody, HCV RNA testing. Multivariable logistic regression models were used to test associations of site characteristics with HBV and HCV services. RESULTS: HBV vaccination was available on-site at 67.7% of 204 HIV treatment sites. Screening for HBV and HCV at HIV care enrollment was reported by 72.1% and 50% of sites, respectively. HBsAg, HBV DNA, HCV antibody and HCV RNA testing were available on-site at 77%, 47.6%, 61.8% and 44.6% of sites, respectively. Sites serving predominately rural (vs. urban) populations were less likely to report on-site availability of HBV DNA (odds ratio (OR):0.07; 95% confidence interval (CI):0.01-0.68;P=0.02), HCV antibody (OR=0.18; 95% CI:0.04-0.92;P=0.04) and HCV RNA (OR=0.10; 95% CI:0.01-0.90;P=0.04) testing. CONCLUSION: Life-saving services such as HBV vaccination, HBsAg and HCV antibody testing were available on-site at most HIV treatment sites participating in the IeDEA network. Lower availability at rural sites suggests that expansion of services is important to eliminate HBV and HCV as public health problems in people receiving HIV care.