Prevalence and predictors of liver steatosis and fibrosis in unselected patients with HIV mono-infection. Issue 12 (December 2016)

• Record Type: Journal Article
• Authors: Lombardi, Rosa; Sambatakou, Helen; Mariolis, Ilias; Cokkinos, Demosthenis; Papatheodoridis, George V.; Tsochatzis, Emmanuel A.
• Is Part Of: Digestive and liver disease. Volume 48:Issue 12(2016)
• Page Start: 1471
• Page End: 1477
• Publication Date: 2016-12
• Subjects: APRI -- Diagnostic accuracy -- Elastography -- FIB4 -- NAFLD -- Non-invasive assessment; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; 616.33005
• DOI: 10.1016/j.dld.2016.08.117
• Languages: English
• ISSNs: 1590-8658

Abstract

Abstract: Objectives: Significant liver disease may develop in HIV mono-infected patients, usually associated with fatty liver and/or cART exposure. We estimated the prevalence and predictors of hepatic steatosis and fibrosis as assessed by ultrasound and transient elastography (TE). Methods: We enrolled 125 consecutive HIV mono-infected patients who underwent ultrasound and TE. Clinical, biochemical, immunological, virological features and medication history were analysed. Results: Mean age was 39.5 ± 10.3 years and 91% were male. Metabolic syndrome (MS) was present in 9.8%, diabetes in 5.6%, hypertension in 9.7%, dyslipidemia in 32.8%. Increased AST and ALT were found in 5.6% and 16.8% respectively. Eighty-five (68%) patients were on cART (median length of treatment of 3 years, IQR 0–17). Hepatic steatosis was detected in 61 (55%) patients and was independently associated with male sex (OR 14.6, 95% CI 1.44–148.17 ), age (OR1.082, 95% CI 1.01–1.16 ), HOMA (OR 2.56, 95% CI1.101–5.96 ) and GGT (OR1.037, 95% CI1.007 –1.075). Significant fibrosis (stiffness > 7.4 kPa) was present in 22 patients (17.6%) and was significantly associated with MS (OR 3.99, 95% CI 1.001–16.09). Conclusions: Liver fibrosis can develop in asymptomatic HIV mono-infected patients. This is likely associated with NAFLD and usually manifests with normal transaminases. Non-invasive screening for the presence of NAFLD and fibrosis should be considered in the routine care of such patients.