Prevalence and Risk Factors of Moderate-to-Severe Hepatic Steatosis in Human Immunodeficiency Virus Infection: The Copenhagen Co-morbidity Liver Study. (16th May 2020)

• Record Type: Journal Article
• Authors: Kirkegaard-Klitbo, Ditte Marie; Fuchs, Andreas; Stender, Stefan; Sigvardsen, Per Ejlstrup; Kühl, Jørgen Tobias; Kofoed, Klaus Fuglsang; Køber, Lars; Nordestgaard, Børge G; Bendtsen, Flemming; Mocroft, Amanda; Lundgren, Jens; Nielsen, Susanne Dam; Benfield, Thomas
• Is Part Of: Journal of infectious diseases. Volume 222:Number 8(2020)
• Page Start: 1353
• Page End: 1362
• Publication Date: 2020-05-16
• Subjects: comorbidity -- fatty liver disease -- human immunodeficiency virus -- NAFL -- NAFLD; Communicable diseases -- Periodicals; Diseases -- Causes and theories of causation -- Periodicals; Medicine -- Periodicals; Communicable Diseases -- Periodicals; Electronic journals; 616.9
• DOI: 10.1093/infdis/jiaa246
• Languages: English
• ISSNs: 0022-1899

Abstract

Abstract: Background: People with human immunodeficiency virus (PWH) may be at risk of nonalcoholic fatty liver disease. We compared the prevalence of moderate-to-severe hepatic steatosis (M-HS) in PWH with human immunodeficiency virus (HIV)-uninfected controls and determined risk factors for M-HS in PWH. Methods: The Copenhagen Co-Morbidity in HIV Infection study included 453 participants, and the Copenhagen General Population Study included 765 participants. None had prior or current viral hepatitis or excessive alcohol intake. Moderate-to-severe hepatic steatosis was assessed by unenhanced computed tomography liver scan defined by liver attenuation ≤48 Hounsfield units. Adjusted odds ratios (aORs) were computed by adjusted logistic regression. Results: The prevalence of M-HS was lower in PWH compared with uninfected controls (8.6% vs 14.2%, P < .01). In multivariable analyses, HIV (aOR, 0.44; P < .01), female sex (aOR, 0.08; P = .03), physical activity level (aOR, 0.09; very active vs inactive; P < .01), and alcohol (aOR, 0.89 per unit/week; P = .02) were protective factors, whereas body mass index (BMI) (aOR, 1.58 per 1 kg/m 2 ; P < .01), alanine transaminase (ALT) (aOR, 1.76 per 10 U/L; P < .01), and exposure to integrase inhibitors (aOR, 1.28 per year; P = .02) were associated with higher odds of M-HS. Conclusions: Moderate-to-severe hepatic steatosis is less common in PWH compared with demographically comparable uninfected controls. Besides BMI and ALT, integrase inhibitor exposure was associated with higher prevalence of steatosis in PWH.