An Assessment of Liver Disease in HIV-infected and HIV/HBV Co-infected Tanzanians

HIV 感染者和 HIV/HBV 合并感染坦桑尼亚人的肝病评估

• 批准号: 9195719
• 负责人: Claudia A Hawkins
• 金额: $ 15.92万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-01-15 至 2018-01-14
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9195719
• 关键词: Address; Africa; Africa South of the Sahara; African; Age; Alanine; Anti-Retroviral Agents; Aspartate Transaminase; Blood Platelets; Caring; Chronic Hepatitis B; Collaborations; Cross-Sectional Studies; Data; Developed Countries; Developing Countries; Development; Disease Progression; Effectiveness; Functional disorder; Funding; Genetic Variation; Glomerular Filtration Rate; HIV; Health; Hepatitis B; Hepatitis B Prevalence; Hepatitis B e Antigens; High Prevalence; Hypertension; Incidence; Individual; Infection; Kidney; Lamivudine; Liver; Liver Cirrhosis; Liver Fibrosis; Liver diseases; Longitudinal Studies; Mentors; Mono-S; Morbidity - disease rate; Outcome; Patients; Pharmaceutical Preparations; Population; Recording of previous events; Regimen; Renal function; Research; Research Infrastructure; Resources; Risk; Safety; Serum Markers; Site; Tanzania; Tenofovir; Toxic effect; Transferase; Viral Markers; Virus; Virus Diseases; Vulnerable Populations; antiretroviral therapy; co-infection; cohort; disorder risk; effective intervention; high risk; high salt diet; immunological status; improved; indexing; liver injury; mortality; prevent; primary outcome; public health relevance; seropositive; study population; treatment program; viral DNA

DESCRIPTION (provided by applicant): The proposed study "An Assessment of Liver Disease in HIV-infected and HIV/HBV co-infected Tanzanians" aims to assess liver fibrosis in HIV/HBV co-infected as well as HIV and HBV mono- infected individuals in Dar es Salaam, Tanzania. Despite the high burden of HIV/HBV co- infection in sub-Saharan Africa (SSA), there has been very little study of liver disease in HIV/HBV co-infected individuals in these settings. The safety and efficacy of HBV-active therapies has also yet to be determined. Africans with HIV/HBV may be at significantly greater risk of liver disease than co-infected individuals in developed countries because they are infected with HBV much longer than HIV and are frequently exposed to other competing risks of liver injury. In this study, liver disease will be examined in HIV, HBV and HIV/HBV co-infected individuals before and after initiation of HBV-active therapies to determine the amount of liver disease at baseline and the effect of HBV-active therapies on liver disease progression. Liver disease will be assessed using two non-invasive serum markers of liver fibrosis and cirrhosis, aspartate aminotransferase (AST)-to-platelet ratio index (APRI) and Fib-4. We will compare results of individuals with HIV and HBV mono-infection to those with HIV/HBV co-infection to determine whether the risk of liver disease is higher among co-infected individuals (in whom liver disease is known to be accelerated) and whether their liver disease is less responsive to therapy. Renal toxicity of the HBV-active antiretroviral tenofovir (TDF) in HIV/HBV co-infected individuals will also be assessed. This proposal, one of the largest of its kind, is aimed to improve the current gap in understanding of liver disease in these vulnerable populations in SSA.

描述（由申请方提供）：拟定研究“HIV感染和HIV/HBV合并感染的坦桑尼亚人肝脏疾病评估”旨在评估坦桑尼亚达累斯萨拉姆HIV/HBV合并感染以及HIV和HBV单一感染个体的肝纤维化。尽管撒哈拉以南非洲（SSA）的HIV/HBV合并感染负担很高，但在这些环境中对HIV/HBV合并感染个体的肝病研究很少。HBV活性治疗的安全性和有效性也尚未确定。非洲艾滋病毒/HBV感染者可能比发达国家的合并感染者患肝病的风险更大，因为他们感染HBV的时间比感染艾滋病毒的时间长得多，并且经常暴露于其他肝损伤的竞争风险。在本研究中，将在启动HBV活性治疗前后检查HIV、HBV和HIV/HBV合并感染个体的肝病，以确定基线时肝病的数量以及HBV活性治疗对肝病进展的影响。将使用肝纤维化和肝硬化的两种非侵入性血清标志物天冬氨酸转氨酶（AST）与血小板比率指数（APRI）和Fib-4评估肝病。我们将比较HIV和HBV单一感染者与HIV/HBV合并感染者的结果，以确定合并感染者（已知肝病加速）的肝病风险是否更高，以及他们的肝病是否对治疗反应较低。还将评估HBV活性抗逆转录病毒替诺福韦（TDF）在HIV/HBV合并感染个体中的肾毒性。 这项提案是同类提案中规模最大的一项，旨在改善目前在SSA这些弱势群体中对肝脏疾病的理解方面的差距。

项目成果

Brief Report: HIV/HBV Coinfection is a Significant Risk Factor for Liver Fibrosis in Tanzanian HIV-Infected Adults.

• DOI: 10.1097/qai.0000000000001491
• 发表时间: 2017-11-01
• 期刊: Journal of acquired immune deficiency syndromes (1999)
• 作者: Hawkins C;Christian B;Fabian E;Macha I;Gawile C;Mpangala S;Ulenga N;Thio CL;Ammerman LR;Mugusi F;Fawzi W;Green R;Murphy R
• 通讯作者: Murphy R