Prevalence and Factors Associated With Liver Fibrosis Among Adult HIV-Infected Patients Attending Urban and Rural Care Clinics in Uganda

Abstract Background Liver fibrosis is common among HIV-infected patients. Risk factors vary by location. Understanding this variation may inform prevention strategies. We compared the prevalence and correlates of liver fibrosis among HIV-infected patients attending care clinics in Uganda. Methods This was a cross-sectional study involving 2030 HIV-infected patients attending care clinics in urban and rural Uganda. Liver fibrosis was defined as liver stiffness measurement (LSM) >7.1 KPa. Proportions and correlates of liver fibrosis were assessed and compared using logistic regression stratified by gender and site. Results Prevalence of liver fibrosis was higher among participants in the rural clinic (15% vs 11%; P = .017). History of tobacco use (urban P = .022; rural P = .035) and serologic evidence of hepatitis C infection (HCV; urban P = .028; rural P = .03) was associated with liver fibrosis in all men. Elevated liver transaminases (urban P = .002; rural P = .028) and increasing age (urban P = .008; rural P = .052) were risk factors among all women. Tobacco use among women was only a risk factor in those attending the rural clinic (P = .003), and detectable HIV viral load (P = .002) for men in the urban clinic. Conclusions Liver fibrosis is prevalent among HIV-infected persons in Uganda. HIV viral suppression and avoiding tobacco may be strategies to prevent liver fibrosis and cancer risk.

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Faculty Opinions recommendation of A matched cross-sectional study of the association between circulating tissue factor activity, immune activation and advanced liver fibrosis in hepatitis C infection.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.725439406.793505983 ◽

2015 ◽

Author(s):

Philip Rosenthal

Keyword(s):

Hepatitis C ◽

Liver Fibrosis ◽

Immune Activation ◽

Cross Sectional Study ◽

Sectional Study ◽

Factor Activity ◽

Hepatitis C Infection ◽

Cross Sectional ◽

Tissue Factor Activity ◽

Advanced Liver Fibrosis

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CROSS SECTIONAL STUDY OF PREVALENCE AND RISK FACTORS OF HEPATITIS B AND HEPATITIS C INFECTION IN A RURAL VILLAGE OF INDIA

Arquivos de Gastroenterologia ◽

10.1590/s0004-28032015000400013 ◽

2015 ◽

Vol 52 (4) ◽

pp. 321-324 ◽

Cited By ~ 4

Author(s):

Prasad BHATE ◽

Naimish SARAF ◽

Pathik PARIKH ◽

Meghraj INGLE ◽

Aniruddha PHADKE ◽

...

Keyword(s):

Risk Factors ◽

Hepatitis C Virus ◽

Hepatitis C ◽

Hepatitis B ◽

Cross Sectional Study ◽

Blood Product Transfusion ◽

Sectional Study ◽

Hepatitis C Infection ◽

Cross Sectional ◽

Hbsag Positivity

Background - Hepatitis B virus and hepatitis C virus are among the principal causes of severe liver disease. There is limited data of epidemiology of Hepatitis B in community, more so in rural population. Objective - To find the prevalence of hepatitis B and C infection in community and study the risk factors for their transmission. Methods - This was a community based cross sectional study. A total of 1833 randomly selected subjects from a rural area were interviewed for risk factors for transmission and tested for markers of hepatitis B and hepatitis C infection. All the positive card tests were confirmed by ELISA. Results - Out of 2400 subjects, rate for participation was 76.38%. None of the subjects was positive for anti hepatitis C virus antibody. Point prevalence for HBsAg positivity was 0.92. Being healthcare worker and having tattoo were significantly associated with HBsAg positive results. Nose and ear piercing was reported by almost. History of blood or blood product transfusion, I/V drug abuse, multiple sexual partners, unsafe Injections, hemodialysis and any h/o surgery was not associated with HBsAg positivity. Conclusion - Health care workers are at high risk for transmission of hepatitis B. Educating common people regarding mode of transmission of Hepatitis B and C will help to reduce their transmission.

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Risk of Liver Fibrosis According to TSH Levels in Euthyroid Subjects

Journal of Clinical Medicine ◽

10.3390/jcm10071350 ◽

2021 ◽

Vol 10 (7) ◽

pp. 1350

Author(s):

Alba Martínez-Escudé ◽

Guillem Pera ◽

Lluís Rodríguez ◽

Ingrid Arteaga ◽

Carmen Expósito-Martínez ◽

...

Keyword(s):

Liver Fibrosis ◽

General Population ◽

Thyroid Function ◽

Liver Stiffness ◽

Cross Sectional Study ◽

Blood Analysis ◽

Cross Sectional ◽

Alcoholic Fatty Liver ◽

Normal Thyroid ◽

Normal Thyroid Function

Alterations in thyroid function may contribute to the development of liver fibrosis especially in subjects with non-alcoholic fatty liver disease. This study aimed to investigate the risk of liver fibrosis according to low-normal thyroid function in the general population. We performed a descriptive cross-sectional study in subjects from 18–75 years randomly selected from 16 primary health care centers from 2017–2019. Each subject underwent clinical evaluation, physical examination, blood analysis and transient hepatic elastography. Descriptive and multivariate logistic regression analyses were used to identify factors associated with fibrosis. We included 1096 subjects (60 ± 11 years; 61% women); 70% had strict-normal thyroid function and 30% had low-normal thyroid function. Low-normal thyroid function was associated with a higher liver stiffness (LS) values: 5.2 vs. 4.8 kPa (p = 0.001) and a greater prevalence of fibrosis: 6.1 vs. 3% (p = 0.016) and 4.3 vs. 2.1% (p = 0.044) for the cut-off points of ≥8.0 kPa and ≥9.2 kPa, respectively. After adjustment for potential confounding factors, the risk of fibrosis in subjects with low-normal thyroid function was OR 1.54 (p = 0.213). In conclusion, low-normal thyroid function is associated with higher LS values and a greater risk of liver fibrosis in the general population, being dependent on other metabolic factors.

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Risk Factors for Explantation of Breast Implants: A Cross-Sectional Study

Aesthetic Surgery Journal ◽

10.1093/asj/sjaa352 ◽

2021 ◽

Author(s):

Denis Souto Valente ◽

Rafaela Koehler Zanella ◽

Carolina Mattana Mulazzani ◽

Sibelie Souto Valente

Keyword(s):

Risk Factors ◽

Tobacco Use ◽

Breast Augmentation ◽

Current Knowledge ◽

Breast Implant ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Implant Surgery ◽

History Of

Abstract Background Explantation of breast implant surgery (EBIS) is an emerging surgical field. Precise information about patients undergoing EBIS is important for preoperative planning of breast, augmentation, complications management, and to address any medicolegal issues. Objectives The aim of this study was to further extend current knowledge of EBIS risk factors. Methods An analytic cross-sectional study was conducted involving patients who had previously undergone cosmetic breast augmentation and were seeking EBIS. Results The study recruited 138 patients. The average time from implant placement and decision to explantation was 59.1 months. On average, each 1-year increase in age resulted in a 4% increase in the relative risk (RR) of explantation (confidence interval (CI), 1.07-1.21). Patients who were obese or overweight present a 1.5 times higher risk of EBIS (CI 95%, 1.03-2.29). On average, this RR was 40% lower (CI 95%, 0.33-0.91) in patients who never smoked compared with those with a history of tobacco use. Women with mastalgia had a 72% higher RR for EBIS (CI 95%, 1.11-2.65). The RR of EBIS was 5.6 times higher (CI 95%, 2.42-11.47) in patients presenting major Shoenfeld’s criteria for autoimmune/inflammatory syndrome induced by adjuvants (ASIA). The RR of EBIS was 4.3 times higher (CI 95%, 1.96-8.63) in patients presenting minor Shoenfeld’s criteria for ASIA. Conclusions EBIS poses a higher risk to patients who are overweight/obese, have a history of tobacco use, suffer from mastalgia, or present Shoenfeld’s criteria for ASIA. It is important to assess properly these individuals before performing implant surgery for breast augmentation. Level of Evidence: 4

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Prevalence and risk factors for hepatitis C virus infection in Kech District, Balochistan, Pakistan: most infections remain unexplained. A cross-sectional study

Epidemiology and Infection ◽

10.1017/s0950268811001087 ◽

2011 ◽

Vol 140 (4) ◽

pp. 716-723 ◽

Cited By ~ 12

Author(s):

F. AHMED ◽

W. L. IRVING ◽

M. ANWAR ◽

P. MYLES ◽

K. R. NEAL

Keyword(s):

Risk Factors ◽

Hepatitis C ◽

Cross Sectional Study ◽

Hepatitis C Virus Infection ◽

Sectional Study ◽

Hepatitis C Infection ◽

Cross Sectional ◽

Rural Town ◽

High Prevalence ◽

Independent Risk Factors

SUMMARYWe studied a cross-sectional sample of the population of Kech, a small rural town in Pakistan to determine the prevalence and risk factors for hepatitis C infection. The prevalence of hepatitis C was 110 out of 2000 persons (5·5%, 95% confidence interval 4·5–6·5). Higher rates were identified in males. Independent risk factors identified were age ⩾75 years, being a healthcare worker, and injecting drug use. There was a high prevalence of many potential routes of transmission of bloodborne viruses and most people reported at least one potential risk factor.

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Prevalence of hepatitis C infection and risk factors in hospitalized diabetic patients: results of a cross-sectional study

European Journal of Gastroenterology & Hepatology ◽

10.1097/meg.0b013e3282fc73a1 ◽

2008 ◽

Vol 20 (9) ◽

pp. 829-836 ◽

Cited By ~ 14

Author(s):

Jean-François Cadranel ◽

Vincent Di Martino ◽

Guy Lambrey ◽

Catherine Mourlhon ◽

Bernard Nalet ◽

...

Keyword(s):

Risk Factors ◽

Hepatitis C ◽

Cross Sectional Study ◽

Diabetic Patients ◽

Sectional Study ◽

Hepatitis C Infection ◽

Cross Sectional

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A matched cross-sectional study of the association between circulating tissue factor activity, immune activation and advanced liver fibrosis in hepatitis C infection

BMC Infectious Diseases ◽

10.1186/s12879-015-0920-1 ◽

2015 ◽

Vol 15 (1) ◽

Cited By ~ 12

Author(s):

Aimee C Hodowanec ◽

Rebecca D Lee ◽

Kirsten E Brady ◽

Weihua Gao ◽

Stacey Kincaid ◽

...

Keyword(s):

Hepatitis C ◽

Liver Fibrosis ◽

Immune Activation ◽

Cross Sectional Study ◽

Sectional Study ◽

Factor Activity ◽

Hepatitis C Infection ◽

Cross Sectional ◽

Tissue Factor Activity ◽

Advanced Liver Fibrosis

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

The Indonesian Journal of Gastroenterology Hepatology and Digestive Endoscopy ◽

10.24871/2232021180-187 ◽

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.

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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 Care (JIAPAC) ◽

10.1177/2325958218823259 ◽

2019 ◽

Vol 18 ◽

pp. 232595821882325 ◽

Cited By ~ 1

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.

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