Assessment of Liver Fibrosis by Transient Elastography in Patients With HIV and Hepatitis B Virus Coinfection in Nigeria

Human immunodeficiency virus (HIV) significantly accelerates the course of chronic hepatitis B (HBV) disease, resulting in higher rates of liver-related morbidity and mortality in individuals with HIV or HBV alone [1]. There are few data on the burden of liver disease in HIV/HBV–coinfected individuals in sub-Saharan Africa (SSA), where both HIV and HBV are endemic. This is, in part, due to the lack of financial and technological resources needed to investigate liver damage in these populations. Transient elastography (TE), a noninvasive test that measures liver stiffness through pulsed echo ultrasound, is a promising alternative to liver biopsy and has high sensitivity for determining the presence of advanced liver fibrosis in HBV and HIV/HBV coinfection [2]. Using TE, we compared the prevalence of advanced fibrosis and associated risk factors in a cohort of antiretroviral therapy (ART)–naive, HIV-monoinfected, and HIV/HBV–coinfected individuals in Jos, Nigeria. We also assessed the correlation between HBV serological and virological markers and severity of liver disease in HIV/HBV coinfection. We hypothesized that the prevalence of liver disease would be higher in HIV/HBV–coinfected patients than in HIV-monoinfected patients and that risk factors may differ based on the presence or absence of HBV.