Liver Histological Patterns among HIV-Infected Individuals and Associated Factors of Fibrosis in Northwestern Tanzania: Is There a Role for Non-Invasive Tests?

Background: There is a paucity of data on HIV related liver pathologies and fibrosis in Tanzania, a lower middle income country, where there is a high burden of HIV and empirical treatment is the norm due to lack of investigative and management guidelines.This study aimed to determine the liver histological patterns among HIV-infected individuals and associated factors of fibrosis, as well as the role of non-invasive tests in the detection of fibrosis.Patients and Methods: This was an analytical cross-sectional hospital-based study carried out in Mwanza, Tanzania.HIV-infected individuals with suspected but indeterminate liver disease underwent ultrasound guided liver biopsy to determine histological patterns.Non-invasive tests, APRI and FIB-4, were compared with ultrasound-guided liver biopsy in the detection of fibrosis.Logistic regression analyses were performed to assess the association between outcome and exposure variables with a p-value < 0.05 considered statistically significant.Receiver operating characteristic curve analyses were used to compare APRI and FIB-4 performance against ultrasound-guided liver biopsy for the detection of liver fibrosis.Results: A total of 86 participants underwent an ultrasound-guided biopsy and specimen for histopathology.Around 98% of the study participants had histological abnormalities.There was underlying fibrosis in 54.7% of the