The clinicopathological spectrum of liver pathology in a high HIV/AIDS burden country
2nd International Conference on Hepatology
May 09-11, 2016 Chicago, USA

Mark Sonderup

University of Cape Town, South Africa
Groote Schuur Hospital, South Africa

Posters & Accepted Abstracts: J Liver

Abstract:

South Africa is the epicentre of the HIV/AIDS pandemic with an estimated 6.4 million HIV infected people, approximately 3.1 million of whom have initiated antiretroviral therapy (ART) through the national public sector program. TB-HIV coinfection is a significant burden with up to 65% of newly diagnosed sputum positive TB patients and HIV positive whilst viral hepatitis co-infection, notably hepatitis B, being common with 5-15% of the South African population who are positive for HBsAg. HIV-related liver disease has emerged as a significant cause of morbidity and mortality, both in the pre-HAART, but particularly in the HAART era of HIV/AIDS. Most data in this regard has come from high income countries, from high HIV burden countries and very limited and invariable difference existing between high and middle/low income countries. Liver enzyme elevations following the initiation of highly active antiretroviral therapy has been a frequently observed complication of HIV treatment, with grade 3 and 4 hepatotoxicity observed in 8.5-23% of patients. Drug- induced liver injuries (DILI) occur at a greater frequency in HIV positive patients than they do in HIV negative patients and this is unclear. DILI has been observed to be a frequent finding in a longitudinal study of liver pathology in patients with HIV/AIDS in South Africa. More recently, a unique pattern of DILI related to efavirenz has been observed in patients, typically in woman with high baseline CD4 initiating efavirenz based ART. Morbidity and mortality are significant. Findings suggest a disproportionate burden of liver related disease in countries with high HIV burden.

Biography :

Email: msonderup@samedical.co.za