Wekesa Clara, Ocama Ponsiano, Parkes-Ratanshi Rosalind, Kirk Gregory D
Infectious Diseases Institute, Makerere University Kampala, Uganda.
Makerere University, College of Health Sciences Kampala, Uganda.
Dialogues Health. 2022 Jul 5;1:100027. doi: 10.1016/j.dialog.2022.100027. eCollection 2022 Dec.
Following chronic inflammation and other disease specific factors, the risk of liver disease is believed to be higher among HIV-infected patients than in the general population despite shared risk factors. Understanding this differentiated burden and its drivers will inform policy and priority populations for intervention.
This was a cross sectional study among 516 adults attending care clinics in Kampala Uganda. Significant liver fibrosis (SLF) was defined as liver stiffness measurement ≥7.2 KPa identified by Fibroscan®. Data analyses were stratified by HIV status and we performed logistic regression performed to identify correlates.
The prevalence of SLF was higher among HIV un-infected patients ((24% Vs 14%; p0.004). Overall HIV-uninfected patients were more likely to be overweight and or obese, with elevated serum cholesterol levels. Elevated measurement of fatty change in the liver (CAP scores >248 dB/m) was associated with SLF among HIV un-infected patients (OR 2.3 CI (1.0-5.2); = 0.046). Low nadir CD4 counts (200cell/mm3) was predictive of SLF among HIV-infected patients (OR 3.3 CI (1.0-10.7); = 0.05).
The prevalence of SLF was unexpectedly higher among HIV un-infected than HIV affected patients attending care clinics in urban Uganda. This observed burden is most likely driven by non-alcoholic fatty liver disease (NAFLD) resulting from metabolic syndrome.
在经历慢性炎症和其他疾病特定因素后，尽管存在共同的风险因素，但据信艾滋病毒感染患者患肝病的风险高于普通人群。了解这种不同的负担及其驱动因素将为政策制定和干预的重点人群提供依据。
这是一项对乌干达坎帕拉护理诊所的516名成年人进行的横断面研究。显著肝纤维化（SLF）定义为通过Fibroscan®测定的肝脏硬度≥7.2千帕。数据分析按艾滋病毒感染状况分层，并进行逻辑回归以确定相关因素。
未感染艾滋病毒的患者中SLF的患病率更高（24%对14%；p = 0.004）。总体而言，未感染艾滋病毒的患者更有可能超重和/或肥胖，血清胆固醇水平升高。肝脏脂肪变性测量值升高（CAP评分>248分贝/米）与未感染艾滋病毒患者的SLF相关（比值比2.3，置信区间（1.0 - 5.2）；p = 0.046）。低最低点CD4细胞计数（<200个细胞/立方毫米）是艾滋病毒感染患者SLF的预测指标（比值比3.3，置信区间（1.0 - 10.7）；p = 0.05）。
在乌干达城市护理诊所就诊的未感染艾滋病毒的患者中，SLF的患病率出人意料地高于感染艾滋病毒的患者。这种观察到的负担很可能是由代谢综合征导致的非酒精性脂肪性肝病（NAFLD）引起的。
