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Using multivariable logistic regression we identified risk factors for elevated <jats:styled-content style=\"fixed-case\">APRI<\/jats:styled-content> including demographic characteristics, body mass index (<jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content>), <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> clinical and immunological status, and tuberculosis. In the subset tested for hepatitis B surface antigen (<jats:styled-content style=\"fixed-case\">HB<\/jats:styled-content>sAg), we investigated the association of hepatitis B virus co\u2010infection with <jats:styled-content style=\"fixed-case\">APRI<\/jats:styled-content> score. Using Kaplan\u2013Meier analysis and Cox proportional hazards regression we determined the association of elevated <jats:styled-content style=\"fixed-case\">APRI<\/jats:styled-content> with death during <jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 20\u00a0308 adults in the analysis cohort, 1027 (5.1%) had significant liver fibrosis at <jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content> initiation including 616 (3.0%) with cirrhosis. Risk factors for significant fibrosis or cirrhosis included male sex, <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content> &lt;18, <jats:styled-content style=\"fixed-case\">WHO<\/jats:styled-content> clinical stage 3 or 4, <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>4<jats:sup>+<\/jats:sup> count &lt;200 cells\/mm<jats:sup>3<\/jats:sup>, and tuberculosis. Among the 237 (1.2%) who were tested, <jats:styled-content style=\"fixed-case\">HB<\/jats:styled-content>sAg\u2010positive patients had four times the odds (adjusted odds ratio, 4.15; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 1.71\u201310.04) of significant fibrosis compared <jats:styled-content style=\"fixed-case\">HB<\/jats:styled-content>sAg\u2010negatives. Both significant fibrosis (adjusted hazard ratio 1.41, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 1.21\u20131.64) and cirrhosis (adjusted hazard ratio 1.57, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 1.31\u20131.89) were associated with increased all\u2010cause mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Liver fibrosis may be a risk factor for mortality during <jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content> among <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010infected individuals in Africa. <jats:styled-content style=\"fixed-case\">APRI<\/jats:styled-content> is an inexpensive and potentially useful test for liver fibrosis in resource\u2010constrained settings.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.12780","type":"journal-article","created":{"date-parts":[[2015,1,8]],"date-time":"2015-01-08T15:41:07Z","timestamp":1420731667000},"page":"1886-1892","source":"Crossref","is-referenced-by-count":16,"title":["Elevated <scp>AST<\/scp>\u2010to\u2010platelet ratio index is associated with increased all\u2010cause mortality among <scp>HIV<\/scp>\u2010infected adults in Zambia"],"prefix":"10.1111","volume":"35","author":[{"given":"Michael J.","family":"Vinikoor","sequence":"first","affiliation":[{"name":"Department of Medicine University of North Carolina at Chapel Hill Chapel Hill NC USA"},{"name":"Centre for Infectious Disease Research in Zambia Lusaka Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edford","family":"Sinkala","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Zambia Lusaka Zambia"},{"name":"University Teaching Hospital Lusaka 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