ArticleBMC infectious diseases2018
HBV and HIV viral load but not microbial translocation or immune activation are associated with liver fibrosis among patients in South Africa.
Article in BMC infectious diseases, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.
- Systematic review and individual-patient-data meta-analysis of non-invasive fibrosis markers for chronic hepatitis B in Africa.Nature communications · 2023Pooled it
- Association Between HIV-1 RNA Detection Status and HBV DNA Detection: A Patient-Level Retrospective Longitudinal Molecular Study from Istanbul, Türkiye.Diagnostics (Basel, Switzerland) · 2026Article
- Hepatitis B Virus Research in South Africa.Viruses · 2022Review
- Cocaethylene, simultaneous alcohol and cocaine use, and liver fibrosis in people living with and without HIV.Drug and alcohol dependence · 2022Article
- Prevalence and Risk Factors for Hepatic Steatosis in Children With Perinatal HIV on Early Antiretroviral Therapy Compared to HIV-Exposed Uninfected and HIV-Unexposed Children.Frontiers in pediatrics · 2022Article
- Non-Alcoholic Fatty Liver Disease in HIV/HBV Patients - a Metabolic Imbalance Aggravated by Antiretroviral Therapy and Perpetuated by the Hepatokine/Adipokine Axis Breakdown.Frontiers in endocrinology · 2022Review
- Liver Fibrosis during Antiretroviral Treatment in HIV-Infected Individuals. Truth or Tale?Cells · 2021Review
- Article
- Increased Prevalence of Liver Fibrosis and HIV Viremia among Patients with HIV, HBV, and Tuberculosis in Botswana.Pathogens (Basel, Switzerland) · 2020Article
- NADSignal transduction and targeted therapy · 2020Review
- Hepatitis B infection in people living with HIV who initiate antiretroviral therapy in Zimbabwe.Public health action · 2020Article
- Treatment advantage in HBV/HIV coinfection compared to HBV monoinfection in a South African cohort.The Journal of infection · 2020Article
- PPARG as therapeutic target for antifibrotic therapy.EXCLI journal · 2020Article
- Human immunodeficiency virus and hepatotropic viruses co-morbidities as the inducers of liver injury progression.World journal of gastroenterology · 2019Review
- A putative hepatitis B virus sequence motif associated with hepatocellular carcinoma in South African adults.Annals of hepatologyArticle
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCo-infection with HIV negatively impacts the progression of chronic hepatitis B virus (HBV) infection, including causing rapid progression to liver fibrosis. Sub-Saharan Africa represents arguably the most important intersection of high endemicity of both chronic hepatitis B virus (HBV) infection and HIV infection.
methodsWe recruited 46 HBV/HIV-co-infected; 47 HBV-monoinfected; 39 HIV-monoinfected; and 37 HBV/HIV-uninfected patients from Tygerberg Hospital, Cape Town, South Africa. All HIV-infected patients were on antiretroviral therapy for ≥3 months. Liver stiffness measurements were assessed using the Fibroscan (Fibroscan 402, Echosens). Cell-based immunomarkers were measured by flow cytometry. Soluble serum/plasma immunomarkers were measured by Luminex technology and enzyme immunoassays. HIV (COBAS/Ampliprep TaqMan HIV-1) and HBV viral loads (in-house assay) were also performed.
resultsHBV/HIV co-infected patients showed significantly higher levels of immune activation %CD8+/HLA-DR+/CD38+ (median 30%, interquartile range: 17-53) and %CD8+/PD-1 (median 22%, interquartile range: 15-33), p ≤ 0.01 compared to all other study groups. Despite this, the HBV-mono-infected group had the highest proportion of patients with advanced liver fibrosis (≥13 kPa) as measured by Fibroscan (18%). HBV mono-infected patients showed highest expression of most cytokines including IL-17 and basic fibroblastic growth factor. There was significant positive correlation between detectable HIV and HBV viral replication and liver fibrosis but not immune activation or gut translocation. DISCUSSION: Highly-active antiretroviral therapy, including tenofovir, is effective against both HIV and HBV. Earlier therapy in the co-infected patients may therefore have controlled viral replication leading to better fibrosis scores when compared to HBV mono-infection in this study. On-going HBV and HIV viraemia, rather than microbial translocation or immune activation, appear to be the drivers of liver fibrosis. Moderate to advanced liver fibrosis in HBV-mono-infection may well indicate poor access to screening and treatment of HBV infection.
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