TY - JOUR
T1 - Liver Injury Patterns and Hepatic Toxicity among People Living with and without HIV and Attending Care in Urban Uganda
AU - Wekesa, Clara
AU - Parkes-Ratanshi, Rosalind
AU - Kirk, Gregory D.
AU - Ocama, Ponsiano
N1 - Publisher Copyright:
© 2023 Clara Wekesa et al.
PY - 2023
Y1 - 2023
N2 - Introduction. The evaluation of the patterns of liver injury, derived from liver chemistry panels, often may narrow on probable causes of the liver insult especially when coupled with clinical history, examination, and other diagnostic tests. Methods. Among people living with and without HIV and attending care, we used the R ratio to evaluate for liver injury patterns. Liver injury patterns were defined as cholestatic (R<2), mixed (R=2-5), and hepatocellular (R>5). Results. Overall, the proportions of participants with cholestatic liver injury, mixed liver injury, and hepatocellular liver injury were 55%, 34%, and 4%, respectively, with similar distribution when stratified by HIV status. Alcohol use among participants without HIV was associated with all patterns of liver injury (cholestatic liver injury (OR=4.9 CI (1.0-24.2); p=0.054), mixed liver injury (OR=5.3 CI (1.1-27.3); p=0.043), and hepatocellular liver injury (OR=13.2 CI (1.0-167.3); p=0.046)). Increasing age was associated with cholestatic liver injury among participants with HIV (OR=2.3 CI (1.0-5.3); p=0.038). Despite a high hepatitis B prevalence among participants with HIV, there was no association with liver injury. Conclusions. Liver injury is prevalent among both people living with and without HIV in care, and cholestatic liver injury is the most common pattern. Alcohol is associated with all patterns of liver injury and increasing age associated with cholestatic liver injury among people living without HIV and people living with HIV, respectively.
AB - Introduction. The evaluation of the patterns of liver injury, derived from liver chemistry panels, often may narrow on probable causes of the liver insult especially when coupled with clinical history, examination, and other diagnostic tests. Methods. Among people living with and without HIV and attending care, we used the R ratio to evaluate for liver injury patterns. Liver injury patterns were defined as cholestatic (R<2), mixed (R=2-5), and hepatocellular (R>5). Results. Overall, the proportions of participants with cholestatic liver injury, mixed liver injury, and hepatocellular liver injury were 55%, 34%, and 4%, respectively, with similar distribution when stratified by HIV status. Alcohol use among participants without HIV was associated with all patterns of liver injury (cholestatic liver injury (OR=4.9 CI (1.0-24.2); p=0.054), mixed liver injury (OR=5.3 CI (1.1-27.3); p=0.043), and hepatocellular liver injury (OR=13.2 CI (1.0-167.3); p=0.046)). Increasing age was associated with cholestatic liver injury among participants with HIV (OR=2.3 CI (1.0-5.3); p=0.038). Despite a high hepatitis B prevalence among participants with HIV, there was no association with liver injury. Conclusions. Liver injury is prevalent among both people living with and without HIV in care, and cholestatic liver injury is the most common pattern. Alcohol is associated with all patterns of liver injury and increasing age associated with cholestatic liver injury among people living without HIV and people living with HIV, respectively.
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U2 - 10.1155/2023/6717854
DO - 10.1155/2023/6717854
M3 - Article
C2 - 36748010
AN - SCOPUS:85147575530
SN - 2090-3448
VL - 2023
JO - International Journal of Hepatology
JF - International Journal of Hepatology
M1 - 6717854
ER -