HBV and HIV viral load but not microbial translocation or immune activation are associated with liver fibrosis among patients in South Africa
| dc.contributor.author | Maponga, Tongai Gibson | en_ZA |
| dc.contributor.author | Andersson, Monique I. | en_ZA |
| dc.contributor.author | Van Rensburg, Christoffel J. | en_ZA |
| dc.contributor.author | Arends, Joop E. | en_ZA |
| dc.contributor.author | Taljaard, Jantjie | en_ZA |
| dc.contributor.author | Preiser, Wolfgang | en_ZA |
| dc.contributor.author | Glashoff, Richard H. | en_ZA |
| dc.date.accessioned | 2018-05-14T05:38:17Z | |
| dc.date.available | 2018-05-14T05:38:17Z | |
| dc.date.issued | 2018-05-08 | |
| dc.date.updated | 2018-05-13T03:33:17Z | |
| dc.description | CITATION: Maponga, T. G., et al. 2018. HBV and HIV viral load but not microbial translocation or immune activation are associated with liver fibrosis among patients in South Africa. BMC Infectious Diseases, 18:214, doi:10.1186/s12879-018-3115-8. | |
| dc.description | The original publication is available at https://bmcinfectdis.biomedcentral.com | |
| dc.description | Publication of this article was funded by the Stellenbosch University Open Access Fund. | |
| dc.description.abstract | Background: Co-infection with HIV negatively impacts the progression of chronic hepatitis B virus (HBV) infection, including causing rapid progression to liver fibrosis. Sub-Saharan Africa represents arguably the most important intersection of high endemicity of both chronic hepatitis B virus (HBV) infection and HIV infection. Methods: We recruited 46 HBV/HIV-co-infected; 47 HBV-monoinfected; 39 HIV-monoinfected; and 37 HBV/HIV-uninfected patients from Tygerberg Hospital, Cape Town, South Africa. All HIV-infected patients were on antiretroviral therapy for ≥3 months. Liver stiffness measurements were assessed using the Fibroscan (Fibroscan 402, Echosens). Cell-based immunomarkers were measured by flow cytometry. Soluble serum/plasma immunomarkers were measured by Luminex technology and enzyme immunoassays. HIV (COBAS/Ampliprep TaqMan HIV-1) and HBV viral loads (in-house assay) were also performed. Results: HBV/HIV co-infected patients showed significantly higher levels of immune activation %CD8+/HLA-DR+/CD38+ (median 30%, interquartile range: 17–53) and %CD8+/PD-1 (median 22%, interquartile range: 15–33), p ≤ 0.01 compared to all other study groups. Despite this, the HBV-mono-infected group had the highest proportion of patients with advanced liver fibrosis (≥13 kPa) as measured by Fibroscan (18%). HBV mono-infected patients showed highest expression of most cytokines including IL-17 and basic fibroblastic growth factor. There was significant positive correlation between detectable HIV and HBV viral replication and liver fibrosis but not immune activation or gut translocation. Discussion: Highly-active antiretroviral therapy, including tenofovir, is effective against both HIV and HBV. Earlier therapy in the co-infected patients may therefore have controlled viral replication leading to better fibrosis scores when compared to HBV mono-infection in this study. On-going HBV and HIV viraemia, rather than microbial translocation or immune activation, appear to be the drivers of liver fibrosis. Moderate to advanced liver fibrosis in HBV-mono-infection may well indicate poor access to screening and treatment of HBV infection. | |
| dc.description.uri | https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-018-3115-8 | |
| dc.description.version | Publisher's version | |
| dc.identifier.citation | Maponga, T. G., et al. 2018. HBV and HIV viral load but not microbial translocation or immune activation are associated with liver fibrosis among patients in South Africa. BMC Infectious Diseases, 18:214, doi:10.1186/s12879-018-3115-8 | |
| dc.identifier.issn | 1471-2334 (online) | |
| dc.identifier.other | doi:10.1186/s12879-018-3115-8 | |
| dc.identifier.uri | http://hdl.handle.net/10019.1/103993 | |
| dc.language.iso | en_ZA | en_ZA |
| dc.publisher | BioMed Central | |
| dc.rights.holder | Author retains copyright | |
| dc.subject | HIV infections | en_ZA |
| dc.subject | Hepatitis B | en_ZA |
| dc.subject | Cytokines | en_ZA |
| dc.subject | Antiretroviral agents | en_ZA |
| dc.subject | Liver -- Diseases | en_ZA |
| dc.title | HBV and HIV viral load but not microbial translocation or immune activation are associated with liver fibrosis among patients in South Africa | en_ZA |
| dc.type | Article | en_ZA |