Prevalence and predictors of liver steatosis and fibrosis in unselected patients with HIV mono-infection

详细信息    查看全文

• 作者：Rosa Lombardi^a ; Helen Sambatakou^b ; Ilias Mariolis^b ; Demosthenis Cokkinos^c ; George V. Papatheodoridis^d ; ¹ ; Emmanuel A. Tsochatzis^a ; ¹ ; ^{e.tsochatzis@ucl.ac.uk}
• 关键词：APRI ; Diagnostic accuracy ; Elastography ; FIB4 ; NAFLD ; Non-invasive assessment
• 刊名：Digestive and Liver Disease
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：48
• 期：12
• 页码：1471-1477
• 全文大小：512 K
• 卷排序：48

文摘

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).MethodsWe enrolled 125 consecutive HIV mono-infected patients who underwent ultrasound and TE. Clinical, biochemical, immunological, virological features and medication history were analysed.ResultsMean 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 (OR 1.082, 95% CI 1.01–1.16), HOMA (OR 2.56, 95% CI 1.101–5.96) and GGT (OR 1.037, 95% CI 1.007–1.075). 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).ConclusionsLiver 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.