Transient Elastography in HIV Infected Patients with Liver Steatosis Identifies a High-Risk Group for Non-Alcoholic Steatohepatitis

Author(s): Marina Ferri Pezzini*, Hugo Cheinquer, Alexandre de Araujo, Carlos T. Schmidt-Cerski, Eduardo Sprinz, Fernando Herz-Wolff, Julia Poeta

Journal Name: Current HIV Research
HIV and Viral Immune Diseases

Volume 19 , Issue 4 , 2021


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Graphical Abstract:


Abstract:

Objective: The study aimed to assess the role of TE in HIV-infected patients with NAFLD.

Methods: HIV-infected patients undergoing ART were enrolled between August 2016 and February 2017, following the inclusion criteria: ≥18 years with undetectable HIV viral load. Exclusion criteria included pregnancy, alcohol intake ≥20g/day and co-infection with hepatitis B or C. Patients underwent an abdominal US to diagnose liver steatosis. Significant fibrosis (≥F2) was considered when APRI>1.0, FIB4>3 and liver stiffness ≥7.1kPa. Subjects with TE ≥7.1kPa were prescribed a liver biopsy and the NAFLD Scoring System ≥3 was considered as a diagnosis of NASH. The poisson regression model was used to identify factors associated with liver steatosis.

Results: 98 patients were included. The mean age of the subjects was 49±11 years and 53 (54.1%) were males. Liver steatosis was diagnosed in 31 patients (31.6%) and was independently associated with male sex (PR= 2.18) and higher BMI (PR=1.08). Among the 31 patients with NAFLD, 26 showed results for TE, APRI and FIB4. The prevalence of significant fibrosis assessed by TE, APRI and FIB4 was 26.9%, 6.4% and 3.2%, respectively. Seven patients (26.9%) had a TE result ≥7.1kPa, which was associated with higher triglyceride levels, FIB4 score and CAP values. Liver biopsy was perfomed on six of those with TE ≥7.1kPa and NASH was found in 5 (83.3%) and liver fibrosis without NASH in one.

Conclusion: NAFLD prevalence in HIV-infected patients is higher than the general population. TE ≥7.1kPa was not able to diagnose significant fibrosis but accurately detect a subgroup of patients at a high risk for NASH among HIV monoinfected individuals with steatosis.

Keywords: HIV, AIDS, NASH, NAFLD, steatosis, fibrosis.

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Article Details

VOLUME: 19
ISSUE: 4
Year: 2021
Published on: 24 February, 2021
Page: [311 - 316]
Pages: 6
DOI: 10.2174/1570162X19666210225085002
Price: $65

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