Liver function test abnormalities in Nigerian patients with human immunodeficiency virus and hepatitis B virus co-infection

Iroezindu, Michael; Agbaji, Oche; Daniyam, Comfort A; Isiguzo, Godsent; Isichei, C. O.; Akanbi, Maxwell O

doi:10.1177/0956462412473889

Cited by 16 publications

(15 citation statements)

References 27 publications

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“…4%, P = 0.02) and FIB-4 score (13% versus. 2%, P = 0.001) among HBV coinfected HIV patients compared to HIV monoinfected participants [ 22 ]. A similar trend was observed in the index study where we found that HIV/HBV coinfected participants had eight times higher risk of liver fibrosis than the HBV monoinfected group.…”

Section: Discussionmentioning

confidence: 99%

Liver Fibrosis and Hepatitis B Coinfection among ART Naïve HIV-Infected Patients at a Tertiary Level Hospital in Northwestern Tanzania: A Cross-Sectional Study

Kilonzo

Gunda

Kashasha

et al. 2017

Journal of Tropical Medicine

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Background Liver fibrosis which is a common complication of chronic hepatitis B infection is rarely diagnosed in low-resource countries due to limited capacity to perform biopsy studies. Data on the utilization of noninvasive techniques which are feasible for diagnosis of liver fibrosis in these settings among HIV-infected patients is scarce. The objective of this study was to establish the magnitude of liver fibrosis by using both aspartate-aminotransferase-to-platelets ratio and fibrosis-4 scores with associated hepatitis B coinfection among antiretroviral therapy naïve HIV-infected patients. MethodsWe reviewed data of 743 adult patients attending HIV clinic with available hepatitis B surface antigen test results. Baseline clinical information was recorded and aspartate-aminotransferase-to-platelet ratio and fibrosis-4 scores were calculated. The cut-off values of 1.5 and 3.25 were used for diagnosis of significant fibrosis by aspartate-aminotransferase-to-platelets ratio and fibrosis-4 scores, respectively. Results The prevalence of liver fibrosis was 3.5% when aspartate-aminotransferase-to-platelet score was used and 4.6% with fibrosis-4 score and they were both significantly higher among patients with hepatitis B coinfection. Younger patients with HIV advanced disease and elevated liver transaminases had increased risk of having hepatitis B coinfection. ConclusionA remarkable number of HIV-infected patients present with liver fibrosis, predominantly those with hepatitis B infection.

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Section: Discussionmentioning

confidence: 99%

Liver Fibrosis and Hepatitis B Coinfection among ART Naïve HIV-Infected Patients at a Tertiary Level Hospital in Northwestern Tanzania: A Cross-Sectional Study

Kilonzo

Gunda

Kashasha

et al. 2017

Journal of Tropical Medicine

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“…Liver enzymes are important biomarkers of the degree of liver damage and are easily available for the monitoring of patients with liver disease in developing countries, where the menace of this disease is high, with inadequate invasive diagnostic facilities [ 49 ]. Elevated alanine aminotransferase (ALT) levels are the most frequently used indicator for chronic liver disease.…”

Section: Current Status Of Knowledgementioning

confidence: 99%

Herb-Induced Liver Injuries in Developing Nations: An Update

Amadi

Orisakwe

2018

Toxics

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The last few decades have seen a rise in the use of herbal supplements, natural products, and traditional medicines. However, there are growing concerns related to the safety and toxicities of these medicines. These herbal medicines are associated with complications such as liver damage with a high incidence of mortalities and morbidities. Clinical manifestations range from asymptomatic cases with abnormal liver functions tests to sudden and severe liver failure necessitating liver transplantation. This work aimed to review the etiology, risk factors, diagnosis, clinical manifestations and selected clinical case reports of herbal hepatotoxicity in developing nations. PubMed and Google Scholar searches were undertaken to identify relevant literature. Furthermore, we scanned the reference lists of the primary and review articles to identify publications not retrieved by electronic searches. Little data exists on clinical cases of herb-induced liver injury in some developing countries such as Nigeria, as most incidences are either not reported to health care providers or reports from hospitals go unpublished. Studies in Nigeria have highlighted a possible correlation between use of herbs and liver disease. In Uganda, and association between the use of traditional herbal medicine with liver fibrosis in HIV-infected and non-HIV patients was demonstrated. Reports from China have revealed incidences of acute liver failure as a result of herbal medicine use. The actual incidence and prevalence of HILI in developing nations remain largely unknown due to both poor pharmacovigilance programs and non-application of emerging technologies. Improving education and public awareness of the potential risks of herbals and herbal products is desirable to ensure that suspected adverse effects are formally reported. There is need for stricter regulations and pre-clinical studies necessary for efficacy and safety.

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“…According to a study in Kenya, 15 HBV/HIV coinfected women have a higher risk for abnormal ALT elevations compared to HIV-1 mono-infected women (HR 2.37; 95% CI 1.1-5.3). In Nigeria, 16 HBV/HIV coinfected patients had impaired liver function enzymes more than the controls (p=0.04). ALP was also significantly higher in the HBV/HIV coinfection group than in the HIV-1 monoinfection group.…”

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confidence: 94%