Increased prevalence of liver fibrosis in people living with HIV without viral hepatitis compared to population controls

2020 ◽  
Author(s):  
Ditte Marie Kirkegaard-Klitbo ◽  
Flemming Bendtsen ◽  
Jens Lundgren ◽  
Robert J de Knegt ◽  
Klaus Fuglsang Kofoed ◽  
...  
Keyword(s):  
Liver Fibrosis ◽  
Transient Elastography ◽  
Liver Stiffness ◽  
People Living With Hiv ◽  
Previous Exposure ◽  
Hiv Status ◽  
Cross Sectional ◽  
Increased Risk ◽  
Living With Hiv ◽  
Population Controls

Abstract Background Liver fibrosis is associated with poor liver related outcomes and mortality. People living with HIV (PWH) may be at increased risk. We aimed to estimate the prevalence and factors associated with liver fibrosis in PWH compared to population controls. Methods Cross-sectional cohort study. We compared 342 PWH with 2,190 population controls aged 50-70 years. Transient elastography was performed and elevated liver stiffness measurement (LSM) defined as 7.6kPa as a proxy for significant liver fibrosis. Adjusted odds ratios (aOR) and 95% confidence intervals (95% CI) were computed by logistic regression. Results The prevalence of elevated LSM was higher in PWH than in uninfected controls (12% vs 7%), p<0.01). HIV infection was independently associated with elevated LSM. In multivariate analysis, elevated LSM was associated with HIV (aOR:1.84 (1.17;2.88), p<0.01); higher age (per decade, aOR:3.34 (1.81;6.18), p<0.01); ALT (per 10 IU/L, aOR:1.25 (1.05;1.49), p<0.01); BMI (per 1 kg/m 2, aOR:1.17 (1.05;1.29), p<0.01) and previous exposure to didanosine (per year aOR:2.26 (1,01;5.06), p=0.05). Conclusions The prevalence of elevated LSM was higher in PWH compared to population controls. Higher age, BMI, ALT, previous exposure to didanosine and a positive HIV status was independently associated with higher odds of elevated LSM.

scholarly journals Liver Stiffness, Albuminuria and Chronic Kidney Disease in Patients with NAFLD: A Systematic Review and Meta-Analysis

Biomolecules ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. 105
Author(s):  
Stefano Ciardullo ◽  
Cinzia Ballabeni ◽  
Roberto Trevisan ◽  
Gianluca Perseghin
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Liver Fibrosis ◽  
Statistical Power ◽  
Transient Elastography ◽  
Meta Analysis ◽  
Liver Stiffness ◽  
Significant Heterogeneity ◽  
Cross Sectional ◽  
Increased Risk

An association between liver stiffness, a surrogate measure of liver fibrosis, and chronic kidney disease (CKD) in patients with nonalcoholic fatty liver disease (NAFLD) has been proposed. However, most studies were small and had low statistical power. We systematically searched PubMed-MEDLINE and Scopus from inception to August 2021 for cross-sectional or cohort studies reporting the association between liver stiffness diagnosed by vibration controlled transient elastography (VCTE) and renal dysfunction. The primary outcome was CKD, defined as a composite of urinary albumin to creatinine ratio (UACR) ≥ 30 mg/g and estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2. Measures of association from individual studies were meta-analyzed using random effects models. Of the 526 titles initially scrutinized, 7 cross-sectional studies fulfilled the criteria and were included. For CKD, risk was higher in patients with liver fibrosis assessed by VCTE, compared with patients without (n = 5 studies: OR 2.49, 95% CI 1.89–3.29; test for overall effect z = 6.475, p < 0.001). When increased UACR was considered as an outcome, elevated liver stiffness was associated with a significantly increased risk as well (n = 3 studies: OR 1. 98 95% CI 1.29–3.05; test for overall effect z = 3.113, p = 0.002). Neither analysis showed significant heterogeneity (I2 = 0% and I2 = 46.5%, respectively for the two outcomes). This meta-analysis indicates that elevated liver stiffness is associated with increased odds of kidney outcomes among patients with NAFLD. Wider use of VCTE to screen for advanced fibrosis might help identify patients at risk of end-stage renal disease.

scholarly journals TSH Levels as an Independent Risk Factor for NAFLD and Liver Fibrosis in the General Population

2021 ◽  
Vol 10 (13) ◽  
pp. 2907
Author(s):  
Alba Martínez-Escudé ◽  
Guillem Pera ◽  
Anna Costa-Garrido ◽  
Lluís Rodríguez ◽  
Ingrid Arteaga ◽  
...  
Keyword(s):  
Risk Factor ◽  
Liver Fibrosis ◽  
General Population ◽  
Transient Elastography ◽  
Atherogenic Dyslipidemia ◽  
Control Group ◽  
Cross Sectional ◽  
Alcoholic Fatty Liver ◽  
Increased Risk ◽  
Tsh Levels

Thyroid hormones may be a risk factor for the development of non-alcoholic fatty liver disease (NAFLD) and its progression to liver fibrosis. The aim of this study is to investigate the relationship between thyroid stimulating hormone (TSH) levels, NAFLD, and liver fibrosis in the general population. A descriptive cross-sectional study was performed in subjects aged 18–75 years randomly selected from primary care centers between 2012 and 2016. Each subject underwent clinical evaluation, physical examination, blood tests and transient elastography. Descriptive and multivariate logistic regression analyses were used to identify factors associated with NAFLD and fibrosis. We included 2452 subjects (54 ± 12 years; 61% female). Subjects with TSH ≥ 2.5 μIU/mL were significantly associated with obesity, atherogenic dyslipidemia, metabolic syndrome (MetS), hypertransaminasemia and altered cholesterol and triglycerides. The prevalence of NAFLD and liver fibrosis was significantly higher in subjects with TSH ≥ 2.5 (μIU/mL). We found a 1.5 times increased risk of NAFLD, 1.8 and 2.3 times increased risk of liver fibrosis for cut-off points of ≥ 8.0 kPa and ≥ 9.2 kPa, respectively, in subjects with TSH ≥ 2.5 μIU/mL compared with TSH < 2.5 μIU/mL (control group), independent of the presence of MetS. These findings remained significant when stratifying TSH, with values ≥ 10 μIU/mL.

scholarly journals COVID-19 Vaccination in People Living with HIV (PLWH) in China: A Cross Sectional Study of Vaccine Hesitancy, Safety, and Immunogenicity

Vaccines ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1458
Author(s):  
Ying Liu ◽  
Junyan Han ◽  
Xin Li ◽  
Danying Chen ◽  
Xuesen Zhao ◽  
...  
Keyword(s):  
T Cell ◽  
Negative Impact ◽  
Immunological Response ◽  
Cd4 T Cell ◽  
Vaccine Hesitancy ◽  
People Living With Hiv ◽  
Cross Sectional ◽  
Cell Counts ◽  
Increased Risk ◽  
Living With Hiv

The administration of COVID-19 vaccines is the primary strategy used to prevent further infections by COVID-19, especially in people living with HIV (PLWH), who are at increased risk for severe symptoms and mortality. However, the vaccine hesitancy, safety, and immunogenicity of COVID-19 vaccines among PLWH have not been fully characterized. We estimated vaccine hesitancy and status of COVID-19 vaccination in Chinese PLWH, explored the safety and impact on antiviral therapy (ART) efficacy and compared the immunogenicity of an inactivated vaccine between PLWH and healthy controls (HC). In total, 27.5% (104/378) of PLWH hesitated to take the vaccine. The barriers included concerns about safety and efficacy, and physician counselling might help patients overcome this vaccine hesitancy. A COVID-19 vaccination did not cause severe side effects and had no negative impact on CD4+ T cell counts and HIV RNA viral load. Comparable spike receptor binding domain IgG titer were elicited in PLWH and HC after a second dose of the CoronaVac vaccine, but antibody responses were lower in poor immunological responders (CD4+ T cell counts < 350 cells/µL) compared with immunological responders (CD4+ T cell counts ≥ 350 cells/µL). These data showed that PLWH have comparable safety and immune response following inactivated COVID-19 vaccination compared with HC, but the poor immunological response in PLWH is associated with impaired humoral response.

Household food insecurity among people living with HIV in Sagamu, Nigeria: A preliminary study

2017 ◽  
Vol 23 (2) ◽  
pp. 95-102 ◽  
Author(s):  
Oluwafolahan O Sholeye ◽  
Victor J Animasahun ◽  
Albert A Salako ◽  
Bankole K Oyewole
Keyword(s):  
Food Insecurity ◽  
Vegetable Consumption ◽  
Systematic Sampling ◽  
Consumption Pattern ◽  
Household Food Insecurity ◽  
People Living With Hiv ◽  
Cross Sectional ◽  
Household Food ◽  
Increased Risk ◽  
Living With Hiv

Background: Household food insecurity has been associated with increased risk of transmission of HIV infection and poor treatment outcomes. This study therefore determined the prevalence of household food insecurity and its associated factors among people living with HIV in Sagamu, Ogun State, Nigeria. Methods: A cross-sectional descriptive study was carried out among 244 adult clients accessing care and support at the teaching hospital in Sagamu, Nigeria, selected via systematic sampling. Data was collected with the aid of a semi-structured, interviewer-administered questionnaire. Data was analysed using SPSS 21.0. Relevant descriptive and inferential statistics were calculated. Informed consent was obtained and strict confidentiality was ensured. Results: The mean age of respondents was 38.8 ± 9.2 years; 84% of respondents were female; 69.3% were married, 12.9% had lost their partners. About 12% spent more than three-quarters of the household income on food. The prevalence of household food insecurity was 71.7%. Food insecurity was associated ( p < 0.05) with educational status; occupation; type of housing; availability of toilet facilities; benefiting from food assistance; delaying drugs to prevent hunger; skipping drugs; vegetable consumption pattern; and exchanging sex for food. Conclusion: The prevalence of household food insecurity in this study was high. Living conditions were significantly associated with food insecurity. Socio-economic conditions need to be improved, to optimize the health and food security status of people living with HIV in Sagamu.

scholarly journals Prevalence and Predictors of Food Insecurity among People Living with and without HIV in the African Cohort Study

2021 ◽  
pp. 1-37
Author(s):  
Cecilia C. Onyenakie ◽  
Raphael U. Nnakwe ◽  
Nicole Dear ◽  
Allahna Esber ◽  
Emmanuel Bahemana ◽  
...  
Keyword(s):  
Food Insecurity ◽  
Elderly Care ◽  
People Living With Hiv ◽  
Hiv Status ◽  
African Countries ◽  
Cross Sectional ◽  
Robust Poisson Regression ◽  
Living With Hiv ◽  
Hiv Policies ◽  
Prevalence Ratios

Abstract Objective: We determined the prevalence and identified predictors of food insecurity in four African countries. Design: Cross-sectional analyses at study enrollment. Setting: From January 2013 to March 2020, people living with HIV (PLWH) and without HIV were enrolled at 12 clinics in Kenya, Uganda, Tanzania, and Nigeria. Participants: Participants reporting not having enough food to eat over the past 12 months or receiving <3 meals/day were defined as food insecure. Robust Poisson regression models were used to estimate unadjusted and adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) for predictors of food insecurity among all participants and separately among PLWH. Results: 1694/3496 participants (48.5%) reported food insecurity at enrollment, with no difference by HIV status. Food insecurity was more common among older participants (50+ years vs. 18-24 years aPR 1.35, 95% CI 1.15-1.59). Having 2-5 (aPR 1.14, 95% CI 1.01-1.30) or >5 dependents (aPR 1.17, 95% CI 1.02- 1.35), and residing in Kisumu West, Kenya (aPR 1.63, 95% CI 1.42-1.87) or Nigeria (aPR 1.20, 95% CI 1.01- 1.41) was associated with food insecurity. Residing in Tanzania (aPR 0.65, 95% CI 0.53-0.80) and increasing education (secondary/above education vs. none/some primary education aPR 0.73, 95% CI 0.66-0.81) was protective against food insecurity. ART-experienced PLWH were more likely to be food secure irrespective of viral load. Conclusion: Food insecurity was highly prevalent in our cohort though not significantly associated with HIV. Policies aimed at promoting education, elderly care, ART access in PLWH, and financial independence could potentially improve food security in Africa.

scholarly journals HIV Disclosure and Quality of Life in People Living with HIV/AIDS in Yogyakarta

2020 ◽  
Vol 4 (2) ◽  
pp. 50-58
Author(s):  
Tutur Irfantoro ◽  
Dwi Kartika Rukmi
Keyword(s):  
Quality Of Life ◽  
Hiv Disclosure ◽  
People Living With Hiv ◽  
Hiv Status ◽  
Cross Sectional ◽  
Hiv Status Disclosure ◽  
Living With Hiv ◽  
Status Disclosure ◽  
Hiv Aids

Background: Victory Plus Foundation is a Non-Government Organization that helps the population directly affected by HIV/AIDS in Yogyakarta. Status disclosure’s research on People Living with HIV/AIDS (PLWHA) in Victory Plus Foundation is scarce. Even though the status disclosure is one of HIV spreading prevention, it has two-sided effects, both negative and positive, so its result can affect the quality of life despite PLWHA having tried to find a support system. Therefore, it is essential to know how the quality of life of PLWHA has opened up their status.Purpose: This study aimed to determine the relationship between HIV status disclosure and the quality of life of PLWHA in the Victory Plus Foundation, Yogyakarta.Method: This descriptive-analytic correlation study with a cross-sectional approach was conducted in June-July 2019 on 68 PLWHA at the Victory Plus Foundation. Purposively, samples were asked to fill out a disclosure questionnaire and WHOQOL-BREF. Univariate data presented in descriptions and Chi-Square tested bivariate data.Result: Most of the HIV status disclosure of PLWHA in the Victory Plus foundation was classified into a moderate category (77.9%) and low quality of life (64 %). The bivariate test result found a significant relationship between the HIV status disclosures with the quality of life in general (p = 0.001) with a moderate relationship closeness (r=0.403).Conclusion: Consequently, there is a relationship between the HIV status disclosures with the quality of life of PLWHA in the Victory Plus Foundation in Yogyakarta.

Disclosure of HIV Status Beyond Sexual Partners by People Living with HIV in France: A Call for Help? Results from the National Cross-Sectional Survey ANRS-VESPA2

2016 ◽  
Vol 21 (1) ◽  
pp. 196-206 ◽  
Author(s):  
Fabienne Marcellin ◽  
◽  
Marie Suzan-Monti ◽  
Antoine Vilotitch ◽  
Luis Sagaon-Teyssier ◽  
...  
Keyword(s):  
Sexual Partners ◽  
People Living With Hiv ◽  
Hiv Status ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Living With Hiv

scholarly journals Adherence to Antiretroviral Therapy and Associated Factors among People Living with HIV/AIDS in Hara Town and Its Surroundings, North-Eastern Ethiopia: A Cross-Sectional Study

1970 ◽  
Vol 29 (3) ◽  
Author(s):  
Tesfaye Aychew Legesse ◽  
Melese Abate Reta
Keyword(s):  
Associated Factors ◽  
Cross Sectional Study ◽  
People Living With Hiv ◽  
Art Adherence ◽  
Drug Side Effects ◽  
Hiv Status ◽  
Cross Sectional ◽  
North Eastern ◽  
Living With Hiv

BACKGROUND: Adherence is the most important factor in determining Antiretroviral Therapy (ART) treatment success and long-term viral suppression. Nonadherence to ART led to the human Immunodeficiency Virus (HIV) related morbidity and mortality. Moreover, it intensifies the risk of the emerging drug resistant HIV strains. This study aimed to assess the level of ART adherence and to identify its predictive associated factors among people living with HIV/AIDS in Hara Town and its surroundings, North-Eastern Ethiopia.METHODS: An institutional facility based cross-sectional study was conducted from April-May 2017. A total of 454 individuals were on ART follow-up in the selected ART-clinic, and only 418 patients were recruited. Bivariate and multivariate logistic regression analyses were carried out to identify associated factors. Odds ratio and 95% Confidence Interval (CI) were calculated to determine the level of significance.RESULTS: The level of ART adherence in the study setting was 300 (71.8%). Participants who had not disclosed their HIV status to their families were 88% less likely to adhere to their ART medication than those who had disclosed their HIV status ((Odds ratio (OR): 0.12, 95%CI:0.05-0.58; p<0.001). On the other hand, participants who had not encountered drug side effects were 2.69 times more likely to adhere to their ART medication than those who had ever encountered drug side effects (OR: 2.69, 95%CI:1.27-5.05; p<0.001).CONCLUSION: A very low level of ART adherence was shown in the study population. It was below the recommended good adherence standard. Therefore, patients should get adequate and comprehensive ART adherence counselling before initiation ART treatment and during the follow-up time. 

scholarly journals Liver Fibrosis and Steatosis in Virally Suppressed HIV-Infected Patients with Cytomegalovirus Seropositivity

2022 ◽  
Vol 22 (3) ◽  
pp. 180-187
Author(s):  
Chyntia Olivia Maurine Jasirwan ◽  
Adik Wibowo ◽  
Amal C Sjaaf ◽  
Gita Aprilicia ◽  
Dyah Purnamasari ◽  
...  
Keyword(s):  
Liver Fibrosis ◽  
Clinical Presentation ◽  
Transient Elastography ◽  
Liver Stiffness ◽  
Human Herpesvirus ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Positive Correlation ◽  
Coefficient Corrélation ◽  
One Year

Background: Cytomegalovirus (CMV) is a human herpesvirus common in people with human immunodeficiency virus (HIV). In a patient with immunocompetence, long periodic asymptomatic CMV might affect to develop the abnormal liver function and contribute to non-AIDS defining morbidity, including chronic liver disease. This study aims to know the prevalence of liver fibrosis and steatosis in virally suppressed HIV infected patients with CMV reactive and summarize the correlation of clinical presentation with liver fibrosis and steatosis in these subjects.Method: A cross-sectional study in HIV Integrated Care Unit, Cipto Mangunkusumo Hospital, was conducted from April 2019 until June 2020. Subjects enrolled in this study were suppressed HIV patients aged between 30-40 years with positive IgG CMV and already using stable ART for at least one year. Transient elastography measured the liver stiffness. Patients with liver stiffness above 7 kPa were defined as having significant liver fibrosis. In addition, Spearman correlation was conducted to evaluate the correlation of clinical presentation of subjects related to liver fibrosis and steatosis. Results: A total of subjects was included in this study. Dominantly male (62.5%) with average age 38 ± 4.68 years. The median amount of CMV DNA was 466 (17-21284) copy/ml. Significant Fibrosis was found in 17/80 (21%) subjects. In this study, clinical parameters correlated with liver fibrosis were insulin, glucose fasting, Homa IR, triglyceride, HDL, and platelet. A medium positive correlation was found in insulin, and Homa IR, with coefficient correlation for insulin, was r = 0.475, p 0.001; and coefficient correlation for Homa IR was r = 0 .487, p 0.001.Conclusion: The prevalence of liver fibrosis was 12% in these subjects. In addition, insulin and Homa IR had a positive correlation with increasing liver fibrosis.

scholarly journals Risk of Liver Fibrosis in Hepatitis B Virus and HIV Coinfected Youths Receiving Tenofovir-Containing Antiretroviral Regimen

2019 ◽  
Vol 18 ◽  
pp. 232595821882325 ◽  
Author(s):  
Linda Aurpibul ◽  
Suparat Kanjanavanit ◽  
Apinya Leerapun ◽  
Thanyawee Puthanakit
Keyword(s):  
Hepatitis B Virus ◽  
Liver Fibrosis ◽  
Hepatitis B ◽  
Transient Elastography ◽  
Liver Stiffness ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Therapy Regimen ◽  
B Virus ◽  
Risk Of Progression

Background: Hepatitis B virus (HBV) and HIV coinfection is associated with risk of progression to chronic liver disease. We assessed liver stiffness in HBV-HIV coinfected youths. Methods: A cross-sectional study in HBV-HIV coinfected youths aged 18 to 25 years who received a tenofovir (TDF)-containing antiretroviral therapy regimen for >96 weeks. Measurements included HBV DNA level, HBV serology profiles, and transient elastography (TE). The cutoff for TE results included ≥5.9 kPa for F2-moderate fibrosis, ≥7.4 kPa for F3-severe fibrosis, and ≥9.6 kPa for F4-cirrhosis. Results: From March to December 2016, 15 HBV-HIV coinfected youths with a median duration on TDF-containing regimens of 3.3 years were enrolled. Five (33%) youths had significant liver fibrosis, 3 with F2-moderate, 1 with F3-advanced fibrosis, and 1 with F4-cirrhosis. Other 5 without liver fibrosis had hepatitis B surface e antigen (HBsAg) and hepatitis B surface e antigen (HBeAg) loss. Higher mean alanine transaminase (ALT) was observed among the group with F2-F4 when compared to those with F0. Conclusion: Liver fibrosis was evidenced in HBV-HIV coinfected youths in Thailand. Transient elastography might be considered for those who do not achieve HBsAg loss or have persistent ALT elevation while on treatment.

Sign in / Sign up

Export Citation Format

Share Document