Comparison of non-invasive methods of assessing liver fibrosis in combination ART-experienced Zimbabweans

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dc.contributor.authorNherera, Brendaen_ZA
dc.contributor.authorMhandire, Kudakwasheen_ZA
dc.contributor.authorNyazika, Tinashe K.en_ZA
dc.contributor.authorMakura, Alfreden_ZA
dc.contributor.authorMusarurwa, Cuthberten_ZA
dc.contributor.authorMapondera, Prichard T.en_ZA
dc.contributor.authorStray-Pedersen, Babillen_ZA
dc.contributor.authorMatarira, Hilda T.en_ZA
dc.date.accessioned2020-04-03T06:55:13Z
dc.date.available2020-04-03T06:55:13Z
dc.date.issued2019-04-11
dc.descriptionCITATION: Nherera, B. et al. 2019. Comparison of non-invasive methods of assessing liver fibrosis in combination ART-experienced Zimbabweans. Southern African Journal of HIV Medicine, 20(1):a844, doi.org/10.4102/sajhivmed.v20i1.844.
dc.descriptionThe original publication is available at https://sajhivmed.org.za
dc.description.abstractBackground: The prevalence of morbidity and mortality associated with liver disease among HIV-infected individuals on combination antiretroviral therapy (ART) is high. Early screening of liver disease is essential, as it provides an opportunity for successful treatment. Hence, there is a need for reliable, inexpensive and non-invasive early markers of hepatic damage. Objectives: Non-invasive algorithms are available for assessing the extent of liver fibrosis as markers of ongoing inflammatory damage. This study compared the use of the FibroTest, Fibrosis-4 (FIB-4) index, APRI test and AST:ALT ratio in assessing liver fibrosis in combination ART-experienced individuals. Methods: In a comparative cross-sectional study, 79 participants between the ages of 8 and 62 years were recruited. The performance of each fibrosis algorithm was determined using established cut-off scores for clinically significant liver fibrosis. Results: The prevalence of liver fibrosis as determined by the FibroTest, FIB-4 index, APRI test and AST: ALT ratio were 19.0%, 21.5%, 12.7% and 79.7%, respectively. For individual biomarkers, A-2M concentration ( p < 0.001) and AST activity ( p = 0.003) remained significantly elevated in participants with fibrosis than those without as defined by FibroTest and APRI test, respectively, after adjustments for multiple comparisons. Conclusion: Our data demonstrate a high prevalence of asymptomatic liver fibrosis among combination ART-experienced individuals in Zimbabwe, and this warrants adequate monitoring of liver fibrosis in individuals on ART. Discordance of fibrosis results among the algorithms and individual biomarkers and calls for further work in identifying optimal biomarkers for detection of asymptomatic fibrosis.en_ZA
dc.description.versionPublisher's version
dc.format.extent6 pages ; illustrations
dc.identifier.citationNherera, B. et al. 2019. Comparison of non-invasive methods of assessing liver fibrosis in combination ART-experienced Zimbabweans. Southern African Journal of HIV Medicine, 20(1):a844, doi.org/10.4102/sajhivmed.v20i1.844.
dc.identifier.issn2078-6751 (online)
dc.identifier.issn1608-9693 (print)
dc.identifier.otherdoi.org/10.4102/sajhivmed.v20i1.844
dc.identifier.urihttp://hdl.handle.net/10019.1/107652
dc.language.isoen_ZAen_ZA
dc.publisherAOSIS
dc.rights.holderAuthors retain copyright
dc.subjectLiver -- Fibrosis -- Examinationen_ZA
dc.subjectHIV-positive persons -- Zimbabween_ZA
dc.subjectHighly active antiretroviral therapy -- Risk factorsen_ZA
dc.titleComparison of non-invasive methods of assessing liver fibrosis in combination ART-experienced Zimbabweansen_ZA
dc.typeArticleen_ZA
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