Lombardi, R;
Sambatakou, H;
Mariolis, I;
Cokkinos, D;
Papatheodoridis, GV;
Tsochatzis, EA;
(2016)
Prevalence and predictors of liver steatosis and fibrosis in unselected patients with HIV mono-infection.
Digestive and Liver Disease
, 48
(12)
pp. 1471-1477.
10.1016/j.dld.2016.08.117.
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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 (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). 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.
| Type: | Article |
|---|---|
| Title: | Prevalence and predictors of liver steatosis and fibrosis in unselected patients with HIV mono-infection |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.dld.2016.08.117 |
| Publisher version: | http://dx.doi.org/10.1016/j.dld.2016.08.117 |
| Language: | English |
| Additional information: | Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/ |
| Keywords: | APRI; Diagnostic accuracy; Elastography; FIB4; NAFLD; Non-invasive assessment |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Inst for Liver and Digestive Hlth |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/1528792 |
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