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

Type of publication Peer-reviewed
Publikationsform Original article (peer-reviewed)
Author Wandeler Gilles, Mulenga Lloyd, Vinikoor Michael J, Kovari Helen, Battegay Manuel, Calmy Alexandra, Cavassini Matthias, Bernasconi Enos, Schmid Patrick, Bolton-Moore Carolyn, Sinkala Edford, Chi Benjamin H, Egger Matthias, Rauch Andri, Rauch Andri,
Project Swiss HIV Cohort Study (SHCS)
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Original article (peer-reviewed)

Journal International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
Page(s) 97 - 102
Title of proceedings International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
DOI 10.1016/j.ijid.2016.08.028

Open Access

URL https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5363287/
Type of Open Access Repository (Green Open Access)

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.
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