Burden of Fatty Liver and Hepatic Fibrosis in Persons With HIV: A Diverse Cross-Sectional Us Multicenter Study

Authors

• Samer Gawrieh
• Jordan E Lake
• Paula Debroy
• Julia A Sjoquist
• Montreca Robison
• Mark Tann
• Fatih Akisik
• Surya S Bhamidipalli
• Chandan K Saha
• Kimon Zachary
• Gregory K Robbins
• Samir K Gupta
• Raymond T Chung
• Naga Chalasani
• Kathleen E Corey

Language

English

Publication Date

8-1-2023

Journal

Hepatology

DOI

10.1097/HEP.0000000000000313

PMID

36805976

PMCID

PMC10496090

PubMedCentral® Posted Date

8-1-2024

PubMedCentral® Full Text Version

Author MSS

Abstract

Background aims: The current prevalence of fatty liver disease (FLD) due to alcohol-associated (AFLD) and nonalcoholic (NAFLD) origins in US persons with HIV (PWH) is not well defined. We prospectively evaluated the burden of FLD and hepatic fibrosis in a diverse cohort of PWH.

Approach results: Consenting participants in outpatient HIV clinics in 3 centers in the US underwent detailed phenotyping, including liver ultrasound and vibration-controlled transient elastography for controlled attenuation parameter and liver stiffness measurement. The prevalence of AFLD, NAFLD, and clinically significant and advanced fibrosis was determined. Univariate and multivariate logistic regression models were used to evaluate factors associated with the risk of NAFLD. Of 342 participants, 95.6% were on antiretroviral therapy, 93.9% had adequate viral suppression, 48.7% (95% CI 43%-54%) had steatosis by ultrasound, and 50.6% (95% CI 45%-56%) had steatosis by controlled attenuation parameter ≥263 dB/m. NAFLD accounted for 90% of FLD. In multivariable analysis, old age, higher body mass index, diabetes, and higher alanine aminotransferase, but not antiretroviral therapy or CD4 + cell count, were independently associated with increased NAFLD risk. In all PWH with fatty liver, the frequency of liver stiffness measurement 8-12 kPa was 13.9% (95% CI 9%-20%) and ≥12 kPa 6.4% (95% CI 3%-11%), with a similar frequency of these liver stiffness measurement cutoffs in NAFLD.

Conclusions: Nearly half of the virally-suppressed PWH have FLD, 90% of which is due to NAFLD. A fifth of the PWH with FLD has clinically significant fibrosis, and 6% have advanced fibrosis. These data lend support to systematic screening for high-risk NAFLD in PWH.

Keywords

Humans, Non-alcoholic Fatty Liver Disease, Cross-Sectional Studies, Liver Cirrhosis, Diabetes Mellitus, HIV Infections, Elasticity Imaging Techniques, Liver

Published Open-Access

yes

Recommended Citation

Gawrieh, Samer; Lake, Jordan E; Debroy, Paula; et al., "Burden of Fatty Liver and Hepatic Fibrosis in Persons With HIV: A Diverse Cross-Sectional Us Multicenter Study" (2023). Faculty, Staff and Student Publications. 3555.
https://digitalcommons.library.tmc.edu/uthmed_docs/3555