ArticleTropical medicine & international health : TM & IH2016
Association between hepatitis B co-infection and elevated liver stiffness among HIV-infected adults in Lusaka, Zambia.
Article in Tropical medicine & international health : TM & IH, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 20 citations in OpenAlex.
- Comparison of Hepatitis B Virus Infection in HIV-Infected and HIV-Uninfected Participants Enrolled in a Multinational Clinical Trial: HPTN 052.Journal of acquired immune deficiency syndromes (1999) · 2017Trial
- New Window Into Hepatitis B in Africa: Liver Sampling Combined With Single-Cell Omics Enables Deep and Longitudinal Assessment of Intrahepatic Immunity in Zambia.The Journal of infectious diseases · 2024Article
- Long-term Hepatitis B and Liver Outcomes Among Adults Taking Tenofovir-Containing Antiretroviral Therapy for HBV/HIV Coinfection in Zambia.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Article
- Metabolic causes of liver disease among adults living with HIV from low- and middle-income countries: a cross-sectional study.Journal of the International AIDS Society · 2024Article
- Article
- Detection and quantitation of hepatitis B surface antigen (HBsAg) on dried blood spots: a solution for easy access for hepatitis B diagnosis and elimination in remote areas.The Pan African medical journal · 2022Article
- How Physical Factors Coordinate Virus Infection: A Perspective From Mechanobiology.Frontiers in bioengineering and biotechnology · 2021Review
- Prevalence and Factors Associated With Liver Fibrosis Among Adult HIV-Infected Patients Attending Urban and Rural Care Clinics in Uganda.Open forum infectious diseases · 2020Article
- Evaluation of hepatic and kidney dysfunction among newly diagnosed HIV patients with viral hepatitis infection in Cape Coast, Ghana.BMC research notes · 2019Article
- HIV, syphilis and hepatitis B coinfections in Mkushi, Zambia: a cross-sectional study.F1000Research · 2019Article
- Field performance of the Determine HBsAg point-of-care test for diagnosis of hepatitis B virus co-infection among HIV patients in Zambia.Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology · 2018Article
- Brief Report: HIV/HBV Coinfection is a Significant Risk Factor for Liver Fibrosis in Tanzanian HIV-Infected Adults.Journal of acquired immune deficiency syndromes (1999) · 2017Article
- Impact of Antiretroviral Therapy on Liver Fibrosis Among Human Immunodeficiency Virus-Infected Adults With and Without HBV Coinfection in Zambia.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2017Article
- Hepatitis B testing and treatment in HIV patients in The Gambia-Compliance with international guidelines and clinical outcomes.PloS one · 2017Article
- Hepatitis B and C Virus Co-Infection and Their Association With Liver Disease in Persons With HIV in Nigeria.Journal of the International Association of Providers of AIDS CareArticle
- Risk of Liver Fibrosis in Hepatitis B Virus and HIV Coinfected Youths Receiving Tenofovir-Containing Antiretroviral Regimen.Journal of the International Association of Providers of AIDS CareArticle
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Authors and funding
11 authors at 6 institutions in 5 countries.
Funding
Abstract
objectiveTo describe liver disease epidemiology among HIV-infected individuals in Zambia.
methodsWe recruited HIV-infected adults (≥18 years) at antiretroviral therapy initiation at two facilities in Lusaka. Using vibration controlled transient elastography, we assessed liver stiffness, a surrogate for fibrosis/cirrhosis, and analysed liver stiffness measurements (LSM) according to established thresholds (>7.0 kPa for significant fibrosis and >11.0 kPa for cirrhosis). All participants underwent standardised screening for potential causes of liver disease including chronic hepatitis B (HBV) and C virus co-infection, herbal medicine, and alcohol use. We used multivariable logistic regression to identify factors associated with elevated liver stiffness.
resultsAmong 798 HIV-infected patients, 651 had a valid LSM (median age, 34 years; 53% female). HBV co-infection (12%) and alcohol use disorders (41%) were common and hepatitis C virus co-infection (<1%) was rare. According to LSM, 75 (12%) had significant fibrosis and 13 (2%) had cirrhosis. In multivariable analysis, HBV co-infection as well as male sex, increased age and WHO clinical stage 3 or 4 were independently associated with LSM >7.0 kPa (all P < 0.05). HBV co-infection was the only independent risk factor for LSM >11.0 kPa. Among HIV-HBV patients, those with elevated ALT and HBV viral load were more likely to have significant liver fibrosis than patients with normal markers of HBV activity.
conclusionsHBV co-infection was the most important risk factor for liver fibrosis and cirrhosis and should be diagnosed early in HIV care to optimise treatment outcomes.
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