Liver fibrosis in treatment-naïve HIV-infected and HIV/HBV co-infected patients: Zambia and Switzerland compared.

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State: Public
Version: Final published version
Serval ID
serval:BIB_26BD7125778D
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Liver fibrosis in treatment-naïve HIV-infected and HIV/HBV co-infected patients: Zambia and Switzerland compared.
Journal
International journal of infectious diseases
Author(s)
Wandeler G., Mulenga L., Vinikoor M.J., Kovari H., Battegay M., Calmy A., Cavassini M., Bernasconi E., Schmid P., Bolton-Moore C., Sinkala E., Chi B.H., Egger M., Rauch A.
Working group(s)
for IeDEA-Southern Africa and the Swiss HIV Cohort Study
Contributor(s)
for IeDEA-Southern Africa
ISSN
1878-3511 (Electronic)
ISSN-L
1201-9712
Publication state
Published
Issued date
10/2016
Peer-reviewed
Oui
Volume
51
Pages
97-102
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
To examine the association between hepatitis B virus (HBV) infection and liver fibrosis in HIV-infected patients in Zambia and Switzerland.
HIV-infected adults starting antiretroviral therapy in two clinics in Zambia and Switzerland were included. Liver fibrosis was evaluated using the aspartate aminotransferase-to-platelet-ratio index (APRI), with a ratio >1.5 defining significant fibrosis and a ratio >2.0 indicating cirrhosis. The association between hepatitis B surface antigen (HBsAg) positivity, HBV replication, and liver fibrosis was examined using logistic regression.
In Zambia, 96 (13.0%) of 739 patients were HBsAg-positive compared to 93 (4.5%) of 2058 in Switzerland. HBsAg-positive patients were more likely to have significant liver fibrosis than HBsAg-negative ones: the adjusted odds ratio (aOR) was 3.25 (95% confidence interval (CI) 1.44-7.33) in Zambia and 2.50 (95% CI 1.19-5.25) in Switzerland. Patients with a high HBV viral load (≥20000 IU/ml) were more likely to have significant liver fibrosis compared to HBsAg-negative patients or patients with an undetectable viral load: aOR 3.85 (95% CI 1.29-11.44) in Zambia and 4.20 (95% CI 1.64-10.76) in Switzerland. In both settings, male sex was a strong risk factor for significant liver fibrosis.
Despite the differences in HBV natural history between Sub-Saharan Africa and Europe, the degree of liver fibrosis and the association with important risk factors were similar.

Keywords
Adolescent, Adult, Aspartate Aminotransferases/metabolism, Blood Platelets/metabolism, Cohort Studies, Coinfection, Cross-Sectional Studies, Female, HIV Infections/complications, HIV Infections/epidemiology, HIV Infections/virology, Hepatitis B/complications, Hepatitis B/epidemiology, Hepatitis B/virology, Hepatitis B Surface Antigens/analysis, Hepatitis B virus/genetics, Hepatitis B virus/immunology, Hepatitis B virus/physiology, Humans, Liver Cirrhosis/complications, Liver Cirrhosis/epidemiology, Liver Cirrhosis/virology, Male, Middle Aged, Risk Factors, Switzerland/epidemiology, Viral Load, Young Adult, Zambia/epidemiology, HIV, Hepatitis B infection, Liver fibrosis, Switzerland, Zambia
Pubmed
Web of science
Open Access
Yes
Create date
09/09/2016 10:15
Last modification date
20/08/2019 13:05
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