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Cited by 38Liver Disease Diagnosis and TreatmentHepatitis C virus researchAlcohol Consumption and Health Effects

Alcohol use, viral hepatitis, and liver fibrosis among HIV-positive persons in West Africa: a cross-sectional study

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Jaquet, Antoine, Wandeler, Gilles, Nouaman, Marcellin, Ekouevi, Didier K, Tine, Judicaël, Patassi, Akouda, Coffie, Patrick A, Tanon, Aristophane +3 more·2017·Journal of the International AIDS Society
DOI 10.7448/ias.20.1.21424PMC PMC5467604
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Abstract

Introduction: Liver fibrosis is often the first stage of liver disease in people living with HIV (PLWHIV) in industrialized countries. However, little is known about liver fibrosis and its correlates among PLWHIV in sub‐Saharan Africa. Methods: The study was undertaken in three HIV referral clinics in Côte d’Ivoire, Senegal and Togo. Enrolled PLWHIV underwent a non‐invasive assessment of liver fibrosis combining liver stiffness measure (LSM) with transient elastography and the aspartate aminotransferase‐to‐platelet ratio index (APRI). Significant liver fibrosis was defined as LSM ≥7.1 kPa. Patients were screened for alcohol use (alcohol use disorder identification test (AUDIT)‐C questionnaire), hepatitis B virus (HBV) antigen, hepatitis Delta virus (HDV) antibody and anti‐hepatitis C (HCV) antibody. A logistic regression model was used to identify the factors associated with significant liver fibrosis. Results: A total of 807 PLWHIV were screened at a median age of 43 years (interquartile range (IQR): 36–50). Their median CD4 count was 393 cells/mm 3 (IQR: 234–563) and 682 (84.5%) were on antiretroviral therapy (ART). The prevalence of significant fibrosis was 5.3% (3.8–6.7). Infections with HBV and HCV were identified in 74 (9.2%) and nine (1.1%) participants. Main factors associated with liver fibrosis were alcohol use (AUDIT‐C >6): (odds ratio (OR) = 4.0, confidence interval (CI): 1.2–14.0), (Ref. AUDIT‐C <4) and HBV infection (OR = 2.9, CI: 1.2–7.2). Of the 74 patients positively screened for HBV, 50.0% were on a tenofovir‐based ART regimen. Overall, 10% of HIV/HBV coinfected patients were detected with a positive HDV antibody with a higher prevalence in patients with a significant liver fibrosis (43.0%) compared to others (6.3%) (p = 0.01). Conclusions: Considering the WHO recommendations to screen for HBV infection and treat co‐infected patients with tenofovir‐based ART, screening of alcohol use and brief interventions to prevent alcohol abuse should be implemented in West Africa, especially in HBV/HIV co‐infected patients.

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  • Interventions for AUD have been reported in various general health care settings in sub-Saharan Africa, including HIV or sexually transmitted disease services, antenatal and postnatal care, tuberculosis care, and inpatient and outpatient care.

    “In SSA, interventions for AUD have been reported in various general health care settings (3, 17–27), including services for people with HIV or other sexually transmitted diseases (9, 10, 13–16, 18, 21), antenatal and postnatal care (19, 27–29), care for people with tuberculosis (30, 31), inpatient and outpatient care (20, 26, 32–35).”

    From Integration of Alcohol Use Disorder Interventions in General Health Care Settings in Sub-Saharan Africa: A Scoping Review (2022) · cites this paper as [17]

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  1. [7]World Health Organization. Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection Recommendations for a public health approach - Second edition. Geneva: World Health Organization; 2016 [ cited 2016 12 22]. Available from: http://www.who.int/hiv/pub/guidelines/arv2013/download/en/ 27466667
  2. [20]World Health Organization. Guidelines for the prevention, care and treatment of persons with chronic hepatitis B infection. Geneva: World Health Organization; 2015 [ cited 2016 12 22]. Available from: http://www.who.int/hiv/pub/hepatitis/hepatitis-b-guidelines/en/ 26225396

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Authors
Jaquet, A., Wandeler, G., Nouaman, M., Ekouevi, D. K., Tine, J., Patassi, A., Coffie, P. A., Tanon, A., Seydi, M., Attia, A., & Dabis, F.
Affiliations
  • Université de Bordeaux (FR)
  • University Hospital of Bern (CH)
  • University Hospital Medical Center at Treichville (CI)
  • Centre Hospitalier National Universitaire de Fann (SN)
  • Centre Hospitalier Universitaire de Tokoin (TG)
  • Centre Hospitalier Universitaire de Yopougon (CI)
Corresponding author
Jaquet, Antoine
ORCID
Venue
Journal of the International AIDS Society
Publisher
Wiley
Published
2017-01
Volume
20
Issue
1
Pages
21424-21424
ISSN
1758-2652 (ISSN-L)
DOI
10.7448/ias.20.1.21424
PMC
PMC5467604
OpenAlex
W2590159102
Cited by
38
References
37
Citations by year
2026: 1 · 2025: 1 · 2024: 4 · 2023: 1 · 2022: 6 · 2021: 5 · 2020: 6 · 2019: 6 · 2018: 6 · 2017: 2
FWCI
4.28
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of the International AIDS Society (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Bern Open Repository and Information System (University of Bern) (submittedVersion, cc-by)
  • Open Access CRIS of the University of Bern
Funders
  • National Cancer Institute (NCI)
  • Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
  • National Institute of Allergy and Infectious Diseases (NIAID)
  • National Institute of Drug Abuse (NIDA) (5U01AI069919)
Topics
  • Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
  • Health Sciences › Medicine › Hepatology › Hepatitis C virus research
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
Keywords
liver fibrosis, HIV, alcohol consumption, hepatitis B virus, hepatitis delta virus, hepatitis C, liver stiffness measurement, transient elastography, APRI, HIV/HBV coinfection, tenofovir, antiretroviral therapy, West Africa, sub-Saharan Africa, alcoholism, viral hepatitis screening, CD4 count, antiviral treatment eligibility
MeSH terms
Adult, Alcohol Drinking, Cross-Sectional Studies, Female, Hepatitis, Viral, Human, Humans, Cote d'Ivoire, Liver Cirrhosis, Male, Middle Aged, Senegal, Togo, HIV Infections, Prevalence, CD4 Lymphocyte Count, Coinfection

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