Prevalence and Factors Associated With Liver Fibrosis Among Adult HIV-Infected Patients Attending Urban and Rural Care Clinics in Uganda.

Abstract

<jats:title>Abstract</jats:title> <jats:sec> <jats:title>Introduction</jats:title> <jats:p>Liver fibrosis is common among HIV-infected patients. Risk factors vary by location. Understanding this variation may inform prevention strategies. We compared the prevalence and correlates of liver fibrosis among HIV-infected patients attending care clinics in Uganda.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>Cross sectional study involving 2030 HIV-infected patients attending care clinics in urban and rural Uganda. Liver fibrosis was defined as liver stiffness measurement (LSM) &amp;gt;7.1KPa. Proportions and correlates of liver fibrosis were assessed and compared using logistic regression stratified by gender and site.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Prevalence of liver fibrosis was higher among participants in the rural clinic (15% Vs 11%; p0.017). History of tobacco use (urban p0.022; rural p0.035) and serologic evidence of hepatitis C infection (HCV) (urban p0.028; rural p0.03) was associated with liver fibrosis in all men. Elevated liver transaminases (urban p0.002; rural p0.028) and increasing age (urban p0.008; rural p0.052) were risk factors among all women. Tobacco use among women was only a risk factor in those attending the rural clinic (p0.003) and detectable HIV viral load (p0.002) for men in the urban clinic.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion</jats:title> <jats:p>Liver fibrosis is prevalent among HIV-infected persons in Uganda. HIV viral suppression and avoiding tobacco may be strategies to prevent liver fibrosis and cancer risk.</jats:p> </jats:sec>