Abstract
Liver disease in HIV-infected patients has remained unaddressed in India. This study describes the causes of liver disease in HIV-infected patients and short-term outcome in them. Designed as a prospective observational study, it was conducted at Jawaharlal Institute of Postgraduate Medical Education and Research between September 2011 and March 2013. All consecutive HIV patients (>13 years) attending the antiretroviral therapy clinic or admitted in the Medicine Department were screened, and patients with liver disease or with either HBsAg or anti-HCV antibody positivity were included in the study. Of the 198 patients screened, 51 (26 %) had either abnormal liver function test or had HBsAg or anti-HCV positivity. The median age of the patients was 40 years and 82 % were males. The median CD4 count was 123 cells/mm3. Eighteen (35 %) of them had alcoholic liver disease. Six patients had probable hepatic involvement due to tuberculosis. Ten patients had antituberculosis drug-induced hepatotoxicity. One patient had acute hepatitis B and seven patients had chronic hepatitis B. The cause could not be established in 10 patients (20 %). After a median period of 8 months of follow up, 23 patients had improved, 19 patients (37 %) had died, and six patients had been lost to follow up. Of the patients who had died, 11 patients (58 %) had tuberculosis, and 6 patients (30 %) had decompensated alcoholic liver disease. In conclusion, liver disease in HIV-infected patients was associated with high mortality. Alcohol abuse, tuberculosis, and antituberculosis drugs were the major causes.
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SBS, RRRN, and AH declare that they have no conflict of interest.
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The study was performed in a manner to confirm with the Helsinki Declaration of 1975, as revised in 2000 and 2008 concerning human and animal rights. Also, the authors followed the policy concerning informed consent as shown on the Springer publishing group.
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Shamanna, S.B., Naik, R.R.R. & Hamide, A. Causes of liver disease and its outcome in HIV-infected individuals. Indian J Gastroenterol 35, 310–314 (2016). https://doi.org/10.1007/s12664-016-0676-6
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DOI: https://doi.org/10.1007/s12664-016-0676-6