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The impact of the severity of HIV infection on the prevalence of liver fibrosis in children

Abstract

Background: The fibrotic process in liver fibrosis is faster when there is coinfection with HIV than in Hepatitis B or Hepatitis C mono-infection. Objectives: We sought to compare the presence of liver fibrosis based on Aspartate Aminotransferase to Platelet Ratio Index (APRI) in HIV clinical stage I-II and III-IV. We also sought to identify factors associated with liver fibrosis in HIV-infected children. Methods: The population was HIV-infected children who were registered in 2006-2014 Sanglah hospital’s TApHOd (Treat Asia Pediatric HIV Observational Database) cohort. The cutoff point for fibrosis was APRI > 0.5. The sample was grouped into two outcomes: liver fibrosis and without fibrosis. The associations of liver fibrosis to the severity of HIV clinical stage and other variables were analyzed using Fisher-Exact test. Results: From 81 HIV-infected subjects, 46 were in stage III-IV and 35 in stage I-II. The range of APRI was 0.11 to 12.01. There were 27 subjects with liver fibrosis. There were 21 subjects with liver fibrosis in stage III-IV HIV infection and 6 in stage I-II. The analysis showed in a group of liver fibrosis patients; there are more patients with the severe clinical stage of HIV (p-value = 0.009). Conclusion. Liver fibrosis is more common in the more severe clinical stage of HIV infection in children than in the milder clinical stage. Advanced clinical stage significantly increases the risk for liver fibrosis.

References

  1. REFERENCES
  2. Castellares C, Barreiro P, Martin-Carbonero L, Labarga P, Vispo ME, Casado R, Galindo L, Garcia-Gasco P, Garcia-Samaniego J, Soriano V. Liver cirrhosis in HIV-infected patients: prevalence, aetiology and clinical outcome. Journal of Viral Hepatitis. 2008;15:165-72
  3. Price JC, Seaberg EC, Badri S, Witt MD, D’Acunto K, Thio CL. HIV monoinfection is associated with increased aspartate aminotransferase-to-platelet ratio indeks, a surrogate marker for hepatic fibrosis. The Journal of Infectious Disease. 2012;205:1005-13
  4. Shah AG, Smith PG, Sterling RK. Comparison of FIB-4 and APRI in HIV-HCV coinfected patients with normal and elevated ALT. Journal Digestive Disease Science;2011:56:3038-44
  5. Shiferaw MB, Tulu KT, Zegeye AM, Wubante AA. Liver enzymes abnormalities among highly active antiretroviral therapy experienced and HAART naive HIV-1 infected patients at Debre Tabor hospital, North West Ethiopia: a comparative cross-sectional study. Journal AIDS Research and Treatment. 2016;6:1-7
  6. Price JC, Thio CL. Liver disease in the HIV-infected individual. Journal of Clinical Gastroenterology and Hepatology. 2010;8(12):1002-12
  7. Kruger FC, Daniels CR, Swart G, Brundyn K, Rensburg CV, Kotze M. APRI: A simple bedside marker for advanced fibrosis that can avoid liver biopsy in patients with NAFLD/NASH. South African Medical Journal. 2011;101:477-80
  8. Rubio A, Monpoux F, Huguon E, Truchi R, Triolo V, Rosenthal-Allieri M, Deville A, Rosenthal E, Boutte P, Tran A. Noninvasive procedures to evaluate liver involvement in HIV-1 vertically infected children. Journal of Pediatric Gastroenterology and Nutrition. 2009;49:599-606
  9. Kurniati N. Pedoman penerapan terapi HIV pada anak. Kementerian Kesehatan Republik Indonesia. 2014;48-49
  10. McGoogan KE, MD, Smith PB, MD, MHS, Choi SS, MD, Berman W, MD, Jhaveri R, MD. Performance of the AST to platelet ratio indeks (APRI) as a noninvansive marker of fibrosis in pediatric patients with chronic viral hepatitis. Journal of Pediatric Gastrointestinal Nutrition. 2010;50(3):344-6
  11. Aurpibul L, MD, Bunupuradah T, MD, Sophan S, MD, Boettiger D, MPharm, Wati DK, MD, Nguyen LV, MD, Saphonn V, MD, Hansudewechakul R, MD, Chokephaibulkit K, MD, Lumbiganon P, MD, Truong KH, MD, Do VC, MD, Kumarasamy N, MD, Yusoff NKN, MD, Razali K, MD, Kurniati N, MD, Fong SW, MD, Nallusamy R, MD, Sohn AH, MD. Prevalence and incidence of liver dysfunction and assesment of biomarkers of liver disease in HIV-infected asian children. Journal Pediatric Infectious Disease. 2015;34(6):e153-8
  12. Zhijian Y, Hui L, Weiming Y, Zhanzou L, Zhong C, Jinxin Z, Hongyan W, Xiangbin D, Weizhi Y, Duoyun L, Xiaojun L, Qiwen D. Role of the aspartate transaminase and platelet rasio indeks in assesing hepatic fobrosis and liver inflammation in adolescent patients with HBeAg-positive chronic hepatitis B. Gastroenterology Research and Practice. 2015;6:1-6
  13. Debes JD, Bohjanen PR, Boonstra A. Mechanisms of accelerated liver fibrosis progression during HIV infection. Journal of Clinical and Translational Hepatology. 2016;4:328-35
  14. DallaPiazza M, Amorosa VK, Locallo R, Kostman JR, Re VL. Prevalence and risk factors for significant liver fibrosis among HIV-monoinfected patients. BMC Infectious Diseases. 2010;10:116
  15. Siberry GK, MD, MPH, Patel K, DSc, MPH, Pinto JA, MD, DSc, Puga A, MD, Mirza A, MD, Miller TL, MD, Dyke RBV, MD. Elevated aspartate aminotransferase-to-platelet rasio indeks in perinatally HIV-infected children in the united states. Journal of Pediatric Infectious Diseases. 2014;33:855-7
  16. Sandler NG, Douek DC. Microbial translocation in HIV infection: causes, consequences and treatment opportunities. Nature Reviews Microbiology. 2012;10

How to Cite

Putra, I. B. G. S., Wati, K. D. K., Karyana, I. P. G., Putra, I. G. N. S., & Nesa, N. N. M. (2019). The impact of the severity of HIV infection on the prevalence of liver fibrosis in children. Bali Medical Journal, 8(1), 47–50. https://doi.org/10.15562/bmj.v8i1.977

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Ida Bagus Gde Suwibawa Putra
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Ketut Dewi Kumara Wati
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I Putu Gede Karyana
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I Gusti Ngurah Sanjaya Putra
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Ni Nyoman Metriani Nesa
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