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