The spectrum of liver diseases in HIV infected individuals at an HIV treatment clinic in Kampala, Uganda

Ponsiano Ocama, Michael Katwere, Theresa Piloya, Jordan Feld, Kenneth C. Opio, Andrew Kambugu, Elly Katabira, David L Thomas, Robert Colebunders, Allan Ronald

Research output: Contribution to journalArticle

Abstract

Background: Liver diseases are common in patients with HIV due to viral hepatitis B and C co-infections, opportunistic infections or malignancies, antiretroviral drugs and drugs for opportunistic infections. Objective: To describe the spectrum of liver diseases in HIV-infected patients attending an HIV clinic in Kampala, Uganda. Method: Consecutive patients presenting with jaundice, right upper quadrant pain with fever or malaise, ascites and/or tender hepatomegaly were recruited and underwent investigations to evaluate the cause of their liver disease. Results: Seventy-seven consecutive patients were recruited over an eleven month period. Of these, 23 (30%) had increased transaminases because of nevirapine (NVP) and/or isoniazid (INH) hepatotoxicity. Although 14 (61%) patients with drug-induced liver disease presented with jaundice, all recovered with drug discontinuation. Hepatitis B surface antigen was positive in 11 (15%) patients while anti-hepatitis C antibody was reactive in only 2 (3%). Probable granulomatous hepatitis due to tuberculosis was diagnosed in 7 (9%) patients and all responded to anti-TB therapy. Other diagnoses included alcoholic liver disease, AIDS cholangiopathy, hepatocellular carcinoma, schistosomiasis, haemangioma and hepatic adenoma. Twelve (16%) patients died during follow-up of which 7 (9%) died because of liver disease. Conclusion: Drug history, liver enzyme studies, ultrasound, and hepatitis B and C investigations identified the probable etiology in 60 (78%) of 77 patients with HIV infection presenting with symptoms and/or signs of liver disease.

Original languageEnglish (US)
Pages (from-to)8-12
Number of pages5
JournalAfrican Health Sciences
Volume8
Issue number1
StatePublished - Mar 2008

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Uganda
Liver Diseases
HIV
Therapeutics
Opportunistic Infections
Hepatitis C
Jaundice
Hepatitis B
Pharmaceutical Preparations
Chemical and Drug Induced Liver Injury
Nevirapine
Alcoholic Liver Diseases
Hepatitis C Antibodies
Hepatomegaly
Liver
Schistosomiasis
Isoniazid
Hemangioma
Hepatitis B Surface Antigens
Transaminases

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Ocama, P., Katwere, M., Piloya, T., Feld, J., Opio, K. C., Kambugu, A., ... Ronald, A. (2008). The spectrum of liver diseases in HIV infected individuals at an HIV treatment clinic in Kampala, Uganda. African Health Sciences, 8(1), 8-12.

The spectrum of liver diseases in HIV infected individuals at an HIV treatment clinic in Kampala, Uganda. / Ocama, Ponsiano; Katwere, Michael; Piloya, Theresa; Feld, Jordan; Opio, Kenneth C.; Kambugu, Andrew; Katabira, Elly; Thomas, David L; Colebunders, Robert; Ronald, Allan.

In: African Health Sciences, Vol. 8, No. 1, 03.2008, p. 8-12.

Research output: Contribution to journalArticle

Ocama, P, Katwere, M, Piloya, T, Feld, J, Opio, KC, Kambugu, A, Katabira, E, Thomas, DL, Colebunders, R & Ronald, A 2008, 'The spectrum of liver diseases in HIV infected individuals at an HIV treatment clinic in Kampala, Uganda', African Health Sciences, vol. 8, no. 1, pp. 8-12.
Ocama P, Katwere M, Piloya T, Feld J, Opio KC, Kambugu A et al. The spectrum of liver diseases in HIV infected individuals at an HIV treatment clinic in Kampala, Uganda. African Health Sciences. 2008 Mar;8(1):8-12.
Ocama, Ponsiano ; Katwere, Michael ; Piloya, Theresa ; Feld, Jordan ; Opio, Kenneth C. ; Kambugu, Andrew ; Katabira, Elly ; Thomas, David L ; Colebunders, Robert ; Ronald, Allan. / The spectrum of liver diseases in HIV infected individuals at an HIV treatment clinic in Kampala, Uganda. In: African Health Sciences. 2008 ; Vol. 8, No. 1. pp. 8-12.
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