Abstract
BackgroundLiver 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.MethodsThis 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.ResultsPrevalence 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.ConclusionsLiver 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.
Highlights
Liver fibrosis is common among HIV-infected patients
The prevalence of HCV and the proportional use of alcohol was similar in both d populations from both clinics. te On assessing for the factors associated with liver fibrosis by gender and locality based on p clinic location, we found history of tobacco use and serologic evidence of HCV to be e common risk factors among men from both clinics (Table 3)
The prevalence of liver fibrosis among HIV-infected persons attending the rural care r clinic remains similar to that reported in a previous study (15% vs 17%) done at a time when sc anti-retroviral s therapy (ART) access was limited[26]
Summary
Cross sectional study involving 2030 HIV-infected patients attending care clinics ipt in urban and rural Uganda. Us Results: Prevalence of liver fibrosis was higher among participants in the rural clinic (15% Vs n 11%; p0.017). History of tobacco use (urban p0.022; rural p0.035) and serologic evidence of a hepatitis C infection (HCV) (urban p0.028; rural p0.03) was associated with liver fibrosis in all M men. Elevated liver transaminases (urban p0.002; rural p0.028) and increasing age (urban d p0.008; rural p0.052) were risk factors among all women. Tobacco use among women was te only a risk factor in those attending the rural clinic (p0.003) and detectable HIV viral load p (p0.002) for men in the urban clinic. Ce Conclusion: Liver fibrosis is prevalent among HIV-infected persons in Uganda. HIV viral Ac suppression and avoiding tobacco may be strategies to prevent liver fibrosis and cancer risk
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