Impact of Antiretroviral Therapy on Liver Fibrosis Among Human Immunodeficiency Virus-Infected Adults With and Without HBV Coinfection in Zambia.

Simple item page
dc.contributor.affiliationDepartment of Obstetrics and Gynecology, University of North Carolina at Chapel Hill.
dc.contributor.affiliationDepartment of Medicine, Johns Hopkins University, Baltimore, Maryland.
dc.contributor.affiliationDepartment of Medicine, University of Alabama at Birmingham.
dc.contributor.affiliationInstitute of Social and Preventive Medicine, University of Bern, Switzerland.
dc.contributor.affiliationSchool of Medicine, University of Zambia, and.
dc.contributor.affiliationDepartment of Infectious Diseases, Bern University Hospital, University of Bern, Switzerland.
dc.contributor.affiliationCentre for Infectious Disease Research in Zambia.
dc.contributor.affiliationSchool of Public Health and Family Medicine, University of Cape Town, South Africa.
dc.contributor.affiliationDepartment of Medicine, University Teaching Hospital, Lusaka, Zambia.
dc.contributor.affiliationCIDRZ
dc.contributor.affiliationCentre for Infectious Disease Research in Zambia (CIDRZ)
dc.contributor.authorVinikoor MJ
dc.contributor.authorSinkala E
dc.contributor.authorChilengi R
dc.contributor.authorMulenga LB
dc.contributor.authorChi BH
dc.contributor.authorZyambo Z
dc.contributor.authorHoffmann CJ
dc.contributor.authorSaag MS
dc.contributor.authorDavies MA
dc.contributor.authorEgger M
dc.contributor.authorWandeler G
dc.date.accessioned2025-05-23T11:41:47Z
dc.date.issued2017-May-15
dc.description.abstractBACKGROUND: We investigated changes in hepatic fibrosis, based on transient elastography (TE), among human immunodeficiency virus (HIV)-infected patients with and without hepatitis B virus (HBV) coinfection on antiretroviral therapy (ART) in Zambia. METHODS: Patients' liver stiffness measurements (LSM; kiloPascals [kPa]) at ART initiation were categorized as no or minimal fibrosis (equivalent to Metavir F0-F1), significant fibrosis (F2-F3), and cirrhosis (F4). TE was repeated following 1 year of ART. Stratified by HBV coinfection status (hepatitis B surface antigen positive at baseline), we described LSM change and the proportion with an increase/decrease in fibrosis category. Using multivariable logistic regression, we assessed correlates of significant fibrosis/cirrhosis at 1 year on ART. RESULTS: Among 463 patients analyzed (61 with HBV coinfection), median age was 35 years, 53.7% were women, and median baseline CD4+ count was 240 cells/mm3. Nearly all (97.6%) patients received tenofovir disoproxil fumarate-containing ART, in line with nationally recommended first-line treatment. The median LSM change was -0.70 kPa (95% confidence interval, -3.0 to +1.7) and was similar with and without HBV coinfection. Significant fibrosis/cirrhosis decreased in frequency from 14.0% to 6.7% (P < .001). Increased age, male sex, and HBV coinfection predicted significant fibrosis/cirrhosis at 1 year (all P < .05). CONCLUSION: The percentage of HIV-infected Zambian adults with elevated liver stiffness suggestive of significant fibrosis/cirrhosis decreased following ART initiation-regardless of HBV status. This suggests that HIV infection plays a role in liver inflammation. HBV-coinfected patients were more likely to have significant fibrosis/cirrhosis at 1 year on ART. CLINICAL TRIALS REGISTRATION: NCT02060162.
dc.identifier.doi10.1093/cid/cix122
dc.identifier.urihttps://pubs.cidrz.org/handle/123456789/10554
dc.sourceClinical infectious diseases : an official publication of the Infectious Diseases Society of America
dc.titleImpact of Antiretroviral Therapy on Liver Fibrosis Among Human Immunodeficiency Virus-Infected Adults With and Without HBV Coinfection in Zambia.

Files

Collections

Published