Indian patients with human immunodeficiency virus infection have high prevalence but mild severity of non-alcoholic fatty liver disease.


Journal

Diabetes & metabolic syndrome
ISSN: 1878-0334
Titre abrégé: Diabetes Metab Syndr
Pays: Netherlands
ID NLM: 101462250

Informations de publication

Date de publication:
Dec 2022
Historique:
received: 27 03 2022
revised: 15 11 2022
accepted: 18 11 2022
pubmed: 1 12 2022
medline: 28 12 2022
entrez: 30 11 2022
Statut: ppublish

Résumé

Antiretroviral therapy (ART) has substantially decreased AIDS-related mortality. Non-AIDS related diseases like chronic liver disease are becoming more frequent in people living with HIV-AIDS (PLHA). Non-alcoholic fatty live disease (NAFLD) is a common etiology of liver disease in the general population. Our aim was to analyse the prevalence and risk factors of NAFLD in Indian PLHA. One hundred consecutive adults (age:36.89 ± 10.4 years, males:65%) with HIV infection were prospectively enrolled. Patients with significant alcohol intake, Hepatitis B or Cco-infection, other liver disease, malignancy or HIV stage IV were excluded. Hepatic steatosis was assessed using hepatobiliary ultrasoundand controlled attenuation parameter (CAP). Fibrosis was assessed non-invasively using FIB-4, NAFLD fibrosis score (NFS) and liver stiffness measurement (LSM). Metabolic and HIV-related risk factors were compared between PLHA with and without NAFLD. Prevalence of NAFLD using CAP was 60%. Among patients with NAFLD, 27 (45%) were lean. Majority had mild-moderate steatosis. Advanced fibrosis was present in 1 (1.67%) and 4 (6.67%) patients using NFS and LSM and none using FIB-4. PLHA with NAFLD were more likely to be overweight or obese (OR = 4.21,p = 0.002) with a higher proportion of abdominal obesity (OR:25.26,p = 0.001). Other metabolic comorbidities, duration of HIV infection, duration and type of ART, CD4-count or HIV-stagewere not significantly different among PLHA with or without NAFLD. Prevalence of NAFLD among Indian PLHA is high although most have mild disease. Almost half of these patients are lean. HIV-related factors do not impact the risk of NAFLD.

Sections du résumé

BACKGROUND AND AIMS OBJECTIVE
Antiretroviral therapy (ART) has substantially decreased AIDS-related mortality. Non-AIDS related diseases like chronic liver disease are becoming more frequent in people living with HIV-AIDS (PLHA). Non-alcoholic fatty live disease (NAFLD) is a common etiology of liver disease in the general population. Our aim was to analyse the prevalence and risk factors of NAFLD in Indian PLHA.
METHODS METHODS
One hundred consecutive adults (age:36.89 ± 10.4 years, males:65%) with HIV infection were prospectively enrolled. Patients with significant alcohol intake, Hepatitis B or Cco-infection, other liver disease, malignancy or HIV stage IV were excluded. Hepatic steatosis was assessed using hepatobiliary ultrasoundand controlled attenuation parameter (CAP). Fibrosis was assessed non-invasively using FIB-4, NAFLD fibrosis score (NFS) and liver stiffness measurement (LSM). Metabolic and HIV-related risk factors were compared between PLHA with and without NAFLD.
RESULTS RESULTS
Prevalence of NAFLD using CAP was 60%. Among patients with NAFLD, 27 (45%) were lean. Majority had mild-moderate steatosis. Advanced fibrosis was present in 1 (1.67%) and 4 (6.67%) patients using NFS and LSM and none using FIB-4. PLHA with NAFLD were more likely to be overweight or obese (OR = 4.21,p = 0.002) with a higher proportion of abdominal obesity (OR:25.26,p = 0.001). Other metabolic comorbidities, duration of HIV infection, duration and type of ART, CD4-count or HIV-stagewere not significantly different among PLHA with or without NAFLD.
CONCLUSION CONCLUSIONS
Prevalence of NAFLD among Indian PLHA is high although most have mild disease. Almost half of these patients are lean. HIV-related factors do not impact the risk of NAFLD.

Identifiants

pubmed: 36450180
pii: S1871-4021(22)00296-X
doi: 10.1016/j.dsx.2022.102679
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

102679

Informations de copyright

Copyright © 2022. Published by Elsevier Ltd.

Déclaration de conflit d'intérêts

Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Auteurs

Arka De (A)

Departments of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Ajay Duseja (A)

Departments of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. Electronic address: ajayduseja@yahoo.co.in.

Prayas Badhala (P)

Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Sunil Taneja (S)

Departments of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Aman Sharma (A)

Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Sunil Arora (S)

Immunopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

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