Increased prevalence of liver fibrosis and hiv viremia among patients with hiv, hbv, and tuberculosis in Botswana

Bonolo B. Phinius, Motswedi Anderson, Lynnette Bhebhe, Kabo Baruti, Godiraone Manowe, Wonderful T. Choga, Lucy Mupfumi, Tshepiso Mbangiwa, Mbatshi Mudanga, Sikhulile Moyo, Richard Marlink, Jason T. Blackard, Simani Gaseitsiwe

Research output: Contribution to journalArticlepeer-review


People with concomitant human immunodeficiency virus (HIV) and tuberculosis (TB) have an increased risk of hepatotoxic reactions due to antiretroviral therapy (ART) and anti-TB therapy (ATT). Concomitant hepatitis B virus (HBV) in these patients may lead to poorer health outcomes. To assess liver enzyme levels and immune response in adults with HIV, HBV, and TB, data from 300 antiretroviral-naïve people living with HIV (PLWHIV) were analyzed. The prevalence of HIV/HBV (cHIV/HBV) and HIV/TB (cHIV/TB) was 28% (95% CI: 23.0–33.4) and 10% (95% CI: 6.8–14.0), respectively. HIV/HBV/TB (cHIV/HBV/TB) prevalence was 5.3% (95% CI: 3.1–8.5). There was a statistically significant difference between the groups of participants in HIV viral load (p = 0.004), hemoglobin levels (p = 0.025), and body mass index (p = 0.011). A larger proportion of cHIV/HBV/TB participants (37.5%) had an aspartate aminotransferase to platelet ratio index (APRI) score ≥0.5 (p = 0.013), a lower cutoff for significant liver fibrosis. Immunological non-responders (CD4+ T-cell count <20% gain and HIV viral load <400 copies/mL at 6 months) were observed in all groups except those with cHIV/TB. Our findings support the need to screen for infections that could cause excessive liver damage prior to ATT or ART initiation, such as HBV.

Original languageEnglish (US)
Article number950
Pages (from-to)1-12
Number of pages12
Issue number11
StatePublished - Nov 2020

All Science Journal Classification (ASJC) codes

  • Microbiology (medical)
  • Infectious Diseases
  • Immunology and Microbiology(all)
  • Molecular Biology
  • Immunology and Allergy


  • Africa
  • Botswana
  • Hepatitis B virus
  • Human immunodeficiency virus
  • Tuberculosis


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