Chronic liver disease in HIV patients: Determinants and clinical manifestations

Abstract

Background and Aim: Chronic liver disease (CLD) is a common cause of morbidity and mortality in medical wards of tertiary hospitals in  Nigeria, and the etiology varies from viral hepatitis B and C, retroviral disease, alcoholic and non-alcoholic fatty liver disease, drug toxicity  to several other causes. Liver diseases have also been recognized as a leading cause of death among HIV-infected persons. We aim to  elucidate the pattern of clinical presentation of CLD in non-hepatitis B virus/hepatitis C virus patients who are HIV-seropositive with  minimal alcohol consumption as well as to identify the prevalence and risk factors for CLD in the subjects.

Materials and Methods: This  was a retrospectively analyzed case–control study of 170 HIV-seropositive patients with age- and sex-matched controls seen at the  medical outpatient department and wards of the University of Port Harcourt Teaching Hospital. Sociodemographic, anthropometric,  clinical, and laboratory characteristics were extracted and were analyzed with SPSS version 21.

Results: Sixty-three (37.1%) HIV patients  had clinical manifestations of CLD with fatigue (51, 30%) and hepatomegaly (14, 8.2%) as the commonest symptom and sign, respectively.  Chronic use of medications including highly active antiretroviral therapy (5.1±1.6 years, P = 0.000) and herbal preparations  (n = 20, 11.8%, P = 0.000) were the most significant determinants of CLD. Hypoalbuminemia and low CD4 counts were observed.

Conclusion: CLD is common in HIV patients without viral hepatitis B and C. Early identification of risk factors and proper clinical  evaluation can aid in its mitigation.