Prevalence and dynamics of NAFLD-associated fibrosis in people living with HIV in Vienna from first presentation to last follow-up

Wiener klinische Wochenschrift - Tập 135 - Trang 420-428 - 2022
Caroline Schwarz1,2,3, David Chromy1,2,4, David Bauer1,2,3, Nikki Duong5, Victor Ulrich Schmidbauer6, Michael Schwarz1,2,3, Mattias Mandorfer1,2,7, Armin Rieger4, Michael Trauner1,7, Michael Gschwantler3,8, Thomas Reiberger1,2,7
1Division of Gastroenterology & Hepatology, Department of Medicine III, Medical University of Vienna, Vienna General Hospital, Vienna, Austria
2Vienna HIV & Liver Study Group, Medical University of Vienna, Vienna, Austria
3Department of Internal Medicine IV, Klinik Ottakring, Vienna, Austria
4Department of Dermatology, Medical University of Vienna, Vienna, Austria
5Department of Gastroenterology and Hepatology, Virginia Commonwealth University Medical Center, Richmond, USA
6Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
7Rare Liver Disease (RALID) Center of the ERN RARE-LIVER, Medical University of Vienna, Vienna, Austria
8Sigmund Freud University, Vienna, Austria

Tóm tắt

Non-alcoholic fatty liver disease (NAFLD) is frequent in people living with HIV (PLWH) and may be aggravated by metabolic comorbidities and antiretroviral therapy (ART)-associated adverse effects. We retrospectively assessed epidemiological, clinical and laboratory parameters and ART regimens at HIV diagnosis (BL) and at last follow-up (FU) in 1458 PLWH without viral hepatitis coinfection attending our HIV clinic in 2014–2016. Fibrosis was non-invasively assessed by the NAFLD fibrosis score (NFS). The median age of subjects was 37.8 years, 77.4% were male and 67.2% on ART, median CD4+ count was 356.0 cells/µL. At BL, 503 (34.5%) and 20 (1.4%) PLWH had dyslipidemia and diabetes, respectively. According to the NFS 16 (1.3%) showed advanced fibrosis (NFS ≥ 0.676), among which 1 (6.3%) had diabetes, 7 (43.8%) had dyslipidemia, and 5 (31.3%) were on HIV-protease inhibitors (PI). In addition, 191(15.1%) had intermediate NFS results, while fibrosis was ruled out (NFS ≤ 1.455) in 1065 (83.7%) PLWH. After a median follow-up of 6.3 years, 590 (42.8%) had dyslipidemia and 61 (4.4%) had diabetes. Also, 21 (1.6%) showed advanced fibrosis, of which 10 (47.6%) had diabetes, 4 (19.0%) had dyslipidemia, and 9 (42.9%) were on PI-based ART, 223 (17.4%) had intermediate NFS results, while 1039 (81.0%) showed no fibrosis. During FU, advanced NAFLD fibrosis occurred in 1.3–1.6% of PLWH. Dyslipidemia, diabetes, and PI-based ART were associated with advanced NAFLD fibrosis. Prospective investigations of NAFLD severity and risk factors in PLWH are warranted.

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Wiener klinische Wochenschrift

Tập 135

420-428

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