Symptomatic gallstones and HIV in black South African women: Changing trends of gallstone disease?

Southern African Journal of HIV Medicine

Field Value
Title Symptomatic gallstones and HIV in black South African women: Changing trends of gallstone disease?
Creator Mewa Kinoo, Suman Nagiah, Savania Chuturgoon, Anil Singh, Bhugwan
Subject HIV Medicine; General Surgery; Gastroenterology HIV; ART; gallstone disease; cholesterol gallstones; HIV-induced cholesterol gallstones; ARV-induced cholesterol gallstones
Description Background: The incidence of metabolic disorders in human immunodeficiency virus (HIV) endemic settings is a prevailing burden in developing countries. Cholesterol homeostasis and fat metabolism are altered by HIV and antiretroviral therapy (ART), thereby possibly contributing to complications such as gallstone formation.Objectives: The aim of this study was to evaluate established risk factors for the formation of cholesterol gallstones in black South African women living with HIV (WLHIV).Method: A case series study was conducted of all black South African women undergoing cholecystectomy for gallstone disease over a 1-year period at King Edward VIII Hospital, Durban, South Africa. Age, body mass index (BMI), family history of gallstones, oestrogen exposure and lipograms were compared between WLHIV and uninfected women. Categorical variables were tested using either the Fisher’s exact test or Pearson’s chi-square test. Means were compared using independent t-tests. For non-normally distributed data, the Mann–Whitney U test was used. Statistical tests were two-sided, and p-values of less than 0.05 were considered statistically significant.Results: A total of 52 patients were assessed, 34 HIV-uninfected and 18 WLHIV. The median age of WLHIV versus the uninfected women was 35 and 50 years, respectively, (p = 0.015). A statistically significant number of uninfected women were in the overweight/obese category (BMI 25 kg/m2) compared to the normal weight category (BMI 25 kg/m2) (p 0.001). The number of obese WLHIV did not reach statistical significance.Conclusion: The age of occurrence of gallstone disease amongst black South African WLHIV was significantly lower and fewer women were obese compared with the uninfected women with gallstone disease. These findings differ from known gallstone risk factors in other populations and in uninfected black South African women. This could be attributed to the metabolic alterations caused by HIV infection itself and/or to the long-term use of ART. Larger cohort studies are required to elucidate the role of HIV and ART in cholestatic disease.
Publisher AOSIS
Date 2021-03-25
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — Case series
Format text/html application/epub+zip text/xml application/pdf
Identifier 10.4102/sajhivmed.v22i1.1208
Source Southern African Journal of HIV Medicine; Vol 22, No 1 (2021); 7 pages 2078-6751 1608-9693
Language eng
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Coverage South Africa — Black South African women
Rights Copyright (c) 2021 Suman Mewa Kinoo, Savania Nagiah, Anil Chuturgoon, Bhugwan Singh