The burden, pattern and factors that contribute to periportal fibrosis in HIV-infected  patients in an S. mansoniendemic rural Uganda.

Ponsiano Ocama, Kenneth Christopher Opio, Emmanuel Seremba, Paul Ajal, Betty Stephanie Apica, Emmanuel Odongo Aginya

1. Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
2. Pakwach Health Centre IV, Pakwach, Nebbi District, Uganda
3. Gulu University Medical School.

Abstract
Introduction:Both Human Immunodeficiency Virus (HIV) and S.mansoniinfections are common in Uganda and can cause liver disease. No study has determined co-infection significance in Uganda. We carried out a study on the burden, pattern and factors that contribute to peri-portal fibrosis (PPF) in HIV infected patients attending a Primary healthcare setting at Pakwach.

Methodology: We conducted a cross-sectional study in the HIV clinic at Pakwach health centre IV. Data on demographics, contact with the Nile, CD4+cell count, ART and alcohol use were collected. Urinary Circulating Cathodic Antigen (CCA), was done for S. Mansoni detection. Liver scan was done for presence and pattern of PPF. HBsAg testing was performed on all participants. Data was analyzed using Stata Version 10.

Results:We enrolled 299 patients, median age 39 years (IQR 16), most were female, 210 (73%). Overall, 206 (68.9%) had PPF, majority 191 (92.7%) had pattern c, either alone (63 participants) or in combination with pattern d (128 participants). Age of 30-50 years was significantly associated with PPF (OR 2.28 p-value-0.003)

Conclusion:We found high prevalence ofS. mansoniand PPF in the HIV infected population and age was a significant factor for PPF. We recommend all HIV infected patients be examined routinely for S. mansoni infection for early anti-schistosomal treatment.

Keywords: HIV, S.Mansoni, peri-portal fibrosis.