Cargando…

Tuberculosis and Hepatic Steatosis Are Prevalent Liver Pathology Findings among HIV-Infected Patients in South Africa

Liver disease epidemiology in sub-Saharan Africa has shifted as a result of HIV and the increased use of antiretroviral therapy leading to a need for updated data on common causes of liver disease. We retrospectively reviewed records from all hospitalized patients who had liver biopsy at a single ho...

Descripción completa

Detalles Bibliográficos
Autores principales: Hoffmann, Christopher J., Hoffmann, Jennifer D., Kensler, Caroline, van der Watt, Martin, Omar, Tanvier, Chaisson, Richard E., Martinson, Neil A., Variava, Ebrahim
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4323253/
https://www.ncbi.nlm.nih.gov/pubmed/25668620
http://dx.doi.org/10.1371/journal.pone.0117813
_version_ 1782356517305974784
author Hoffmann, Christopher J.
Hoffmann, Jennifer D.
Kensler, Caroline
van der Watt, Martin
Omar, Tanvier
Chaisson, Richard E.
Martinson, Neil A.
Variava, Ebrahim
author_facet Hoffmann, Christopher J.
Hoffmann, Jennifer D.
Kensler, Caroline
van der Watt, Martin
Omar, Tanvier
Chaisson, Richard E.
Martinson, Neil A.
Variava, Ebrahim
author_sort Hoffmann, Christopher J.
collection PubMed
description Liver disease epidemiology in sub-Saharan Africa has shifted as a result of HIV and the increased use of antiretroviral therapy leading to a need for updated data on common causes of liver disease. We retrospectively reviewed records from all hospitalized patients who had liver biopsy at a single hospital in South Africa from 2001 to 2009 and compared diagnosis by HIV status. During the period of study 262 patients had liver biopsy, 108 (41%) were HIV-infected, 25 (10%) were HIV-sero-negative, and 129 (49%) had unknown or unrecorded HIV status. Overall 81% of biopsies provided additional diagnostic data. Malignancy was the most common finding reported on 56 (21%) biopsies followed by granuloma or TB, hepatic steatosis, and fibrosis or cirrhosis. HIV-infected patients were more likely to have granulomas and steatosis. Half of patients with granulomas were already on TB treatment, suggesting paradoxical reactions or drug induced liver injury may have been important causes of liver inflammation among these patients. We note that TB, paradoxical reactions during TB treatment, possible drug induced liver injury, and hepatic steatosis are important causes of liver pathology among HIV-infected hospitalized patients with unclear etiology of liver disease after initial assessment. Among HIV sero-negative patients, malignancy was the major cause of liver disease. Our findings re-enforce the importance of TB as a diagnosis among HIV-infected individuals.
format Online
Article
Text
id pubmed-4323253
institution National Center for Biotechnology Information
language English
publishDate 2015
publisher Public Library of Science
record_format MEDLINE/PubMed
spelling pubmed-43232532015-02-18 Tuberculosis and Hepatic Steatosis Are Prevalent Liver Pathology Findings among HIV-Infected Patients in South Africa Hoffmann, Christopher J. Hoffmann, Jennifer D. Kensler, Caroline van der Watt, Martin Omar, Tanvier Chaisson, Richard E. Martinson, Neil A. Variava, Ebrahim PLoS One Research Article Liver disease epidemiology in sub-Saharan Africa has shifted as a result of HIV and the increased use of antiretroviral therapy leading to a need for updated data on common causes of liver disease. We retrospectively reviewed records from all hospitalized patients who had liver biopsy at a single hospital in South Africa from 2001 to 2009 and compared diagnosis by HIV status. During the period of study 262 patients had liver biopsy, 108 (41%) were HIV-infected, 25 (10%) were HIV-sero-negative, and 129 (49%) had unknown or unrecorded HIV status. Overall 81% of biopsies provided additional diagnostic data. Malignancy was the most common finding reported on 56 (21%) biopsies followed by granuloma or TB, hepatic steatosis, and fibrosis or cirrhosis. HIV-infected patients were more likely to have granulomas and steatosis. Half of patients with granulomas were already on TB treatment, suggesting paradoxical reactions or drug induced liver injury may have been important causes of liver inflammation among these patients. We note that TB, paradoxical reactions during TB treatment, possible drug induced liver injury, and hepatic steatosis are important causes of liver pathology among HIV-infected hospitalized patients with unclear etiology of liver disease after initial assessment. Among HIV sero-negative patients, malignancy was the major cause of liver disease. Our findings re-enforce the importance of TB as a diagnosis among HIV-infected individuals. Public Library of Science 2015-02-10 /pmc/articles/PMC4323253/ /pubmed/25668620 http://dx.doi.org/10.1371/journal.pone.0117813 Text en © 2015 Hoffmann et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Hoffmann, Christopher J.
Hoffmann, Jennifer D.
Kensler, Caroline
van der Watt, Martin
Omar, Tanvier
Chaisson, Richard E.
Martinson, Neil A.
Variava, Ebrahim
Tuberculosis and Hepatic Steatosis Are Prevalent Liver Pathology Findings among HIV-Infected Patients in South Africa
title Tuberculosis and Hepatic Steatosis Are Prevalent Liver Pathology Findings among HIV-Infected Patients in South Africa
title_full Tuberculosis and Hepatic Steatosis Are Prevalent Liver Pathology Findings among HIV-Infected Patients in South Africa
title_fullStr Tuberculosis and Hepatic Steatosis Are Prevalent Liver Pathology Findings among HIV-Infected Patients in South Africa
title_full_unstemmed Tuberculosis and Hepatic Steatosis Are Prevalent Liver Pathology Findings among HIV-Infected Patients in South Africa
title_short Tuberculosis and Hepatic Steatosis Are Prevalent Liver Pathology Findings among HIV-Infected Patients in South Africa
title_sort tuberculosis and hepatic steatosis are prevalent liver pathology findings among hiv-infected patients in south africa
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4323253/
https://www.ncbi.nlm.nih.gov/pubmed/25668620
http://dx.doi.org/10.1371/journal.pone.0117813
work_keys_str_mv AT hoffmannchristopherj tuberculosisandhepaticsteatosisareprevalentliverpathologyfindingsamonghivinfectedpatientsinsouthafrica
AT hoffmannjenniferd tuberculosisandhepaticsteatosisareprevalentliverpathologyfindingsamonghivinfectedpatientsinsouthafrica
AT kenslercaroline tuberculosisandhepaticsteatosisareprevalentliverpathologyfindingsamonghivinfectedpatientsinsouthafrica
AT vanderwattmartin tuberculosisandhepaticsteatosisareprevalentliverpathologyfindingsamonghivinfectedpatientsinsouthafrica
AT omartanvier tuberculosisandhepaticsteatosisareprevalentliverpathologyfindingsamonghivinfectedpatientsinsouthafrica
AT chaissonricharde tuberculosisandhepaticsteatosisareprevalentliverpathologyfindingsamonghivinfectedpatientsinsouthafrica
AT martinsonneila tuberculosisandhepaticsteatosisareprevalentliverpathologyfindingsamonghivinfectedpatientsinsouthafrica
AT variavaebrahim tuberculosisandhepaticsteatosisareprevalentliverpathologyfindingsamonghivinfectedpatientsinsouthafrica