Burden of liver steatosis and liver fibrosis in a large cohort of people living with HIV.

IF 2.8 3区医学 Q2 INFECTIOUS DISEASES HIV Medicine Pub Date : 2024-11-07 DOI:10.1111/hiv.13730

Montserrat Laguno, Elisa de Lazzari, Leire Berrocal, Alexy Inciarte, Maria Martínez-Rebollar, Lorena de la Mora, Berta Torres, Ana Gonzalez-Cordón, Ivan Chivite, Alberto Foncillas, Júlia Calvo, Abiu Sempere, Juan Ambrosioni, Jose Luís Blanco, J M Miro, Josep Mallolas, Esteban Martínez

{"title":"Burden of liver steatosis and liver fibrosis in a large cohort of people living with HIV.","authors":"Montserrat Laguno, Elisa de Lazzari, Leire Berrocal, Alexy Inciarte, Maria Martínez-Rebollar, Lorena de la Mora, Berta Torres, Ana Gonzalez-Cordón, Ivan Chivite, Alberto Foncillas, Júlia Calvo, Abiu Sempere, Juan Ambrosioni, Jose Luís Blanco, J M Miro, Josep Mallolas, Esteban Martínez","doi":"10.1111/hiv.13730","DOIUrl":null,"url":null,"abstract":"Background: Liver steatosis (LS) and liver fibrosis (LF) can increase the risk of cardiovascular disease in people with HIV, but their prevalence and associated factors are poorly understood. This study aimed to assess the prevalence of and factors associated with LS and LF in a large cohort of people with HIV.Methods: We conducted a cross-sectional study of consecutive people with HIV attending the Clinic of Barcelona from September 2022 to September 2023, excluding those with chronic B or/and C hepatitis virus coinfection. LS was assessed using the Hepatic Steatosis Index (HSI) and Fatty Liver Index (FLI), and LF was assessed using the Non-Alcoholic Fatty Liver Disease Fibrosis Score (NFS), Fibrosis-4 score (FIB-4), and the European AIDS Clinical Society (EACS) algorithm in both the whole cohort (cohort 1) and in a specific cohort more susceptible to liver disease (cohort 2). We identified independent variables associated with LS and LF using logistic regression.Results: Cohort 1 included 4664 people with HIV; 76% and 37% of them had available HSI and FLI data, LS was present in 28% and 19%, respectively. LF risk was present in 1%, 2%, and 1% of people with HIV according to NFS, FIB-4, and EACS algorithm scores, respectively. Cohort 2 included 1345 people with HIV; 60% and 30% of them had available HSI and FLI data, LS affected 55% and 43% and LF 2%, 5%, or 3%, respectively. Factors associated with LS included current CD4 cell count, diabetes, and hypertension, whereas LF was associated with previous exposure to dideoxynucleoside drugs and current CD4 to LF. Current integrase strand transfer inhibitor (INSTI) therapy appeared protective for LF in cohort 1.Conclusions: In this study, one in four people with HIV had LS, and the prevalence rose to one in two in those with cardiovascular risk factors. The prevalence of LF was low, but it should be considered in older people with HIV with low CD4 counts or high aspartate transaminase levels. A possible protective effect from INSTIs deserves further investigation.","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":null,"pages":null},"PeriodicalIF":2.8000,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"HIV Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/hiv.13730","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Liver steatosis (LS) and liver fibrosis (LF) can increase the risk of cardiovascular disease in people with HIV, but their prevalence and associated factors are poorly understood. This study aimed to assess the prevalence of and factors associated with LS and LF in a large cohort of people with HIV.

Methods: We conducted a cross-sectional study of consecutive people with HIV attending the Clinic of Barcelona from September 2022 to September 2023, excluding those with chronic B or/and C hepatitis virus coinfection. LS was assessed using the Hepatic Steatosis Index (HSI) and Fatty Liver Index (FLI), and LF was assessed using the Non-Alcoholic Fatty Liver Disease Fibrosis Score (NFS), Fibrosis-4 score (FIB-4), and the European AIDS Clinical Society (EACS) algorithm in both the whole cohort (cohort 1) and in a specific cohort more susceptible to liver disease (cohort 2). We identified independent variables associated with LS and LF using logistic regression.

Results: Cohort 1 included 4664 people with HIV; 76% and 37% of them had available HSI and FLI data, LS was present in 28% and 19%, respectively. LF risk was present in 1%, 2%, and 1% of people with HIV according to NFS, FIB-4, and EACS algorithm scores, respectively. Cohort 2 included 1345 people with HIV; 60% and 30% of them had available HSI and FLI data, LS affected 55% and 43% and LF 2%, 5%, or 3%, respectively. Factors associated with LS included current CD4 cell count, diabetes, and hypertension, whereas LF was associated with previous exposure to dideoxynucleoside drugs and current CD4 to LF. Current integrase strand transfer inhibitor (INSTI) therapy appeared protective for LF in cohort 1.

Conclusions: In this study, one in four people with HIV had LS, and the prevalence rose to one in two in those with cardiovascular risk factors. The prevalence of LF was low, but it should be considered in older people with HIV with low CD4 counts or high aspartate transaminase levels. A possible protective effect from INSTIs deserves further investigation.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

一大批艾滋病病毒感染者的肝脏脂肪变性和肝纤维化负担。

背景：肝脏脂肪变性（LS）和肝纤维化（LF）会增加艾滋病病毒感染者罹患心血管疾病的风险，但人们对它们的患病率和相关因素知之甚少。本研究旨在评估一大批艾滋病病毒感染者中肝脏脂肪变性和肝纤维化的患病率及其相关因素：我们对 2022 年 9 月至 2023 年 9 月期间在巴塞罗那诊所就诊的连续 HIV 感染者进行了横断面研究，其中不包括慢性乙型或/和丙型肝炎病毒合并感染者。在整个队列（队列 1）和更易患肝病的特定队列（队列 2）中，使用肝脏脂肪变性指数（HSI）和脂肪肝指数（FLI）评估 LS，使用非酒精性脂肪肝纤维化评分（NFS）、纤维化-4 评分（FIB-4）和欧洲艾滋病临床协会（EACS）算法评估 LF。我们利用逻辑回归确定了与 LS 和 LF 相关的独立变量：队列 1 包括 4664 名艾滋病毒感染者；其中 76% 和 37% 的人有 HSI 和 FLI 数据，分别有 28% 和 19% 的人存在 LS。根据NFS、FIB-4和EACS算法评分，分别有1%、2%和1%的HIV感染者存在LF风险。队列2包括1345名HIV感染者；其中60%和30%的人有HSI和FLI数据，LS感染率分别为55%和43%，LF感染率分别为2%、5%或3%。与LS相关的因素包括目前的CD4细胞计数、糖尿病和高血压，而LF则与以前接触过二脱氧核苷类药物和目前的CD4与LF相关。在队列1中，目前的整合酶链转移抑制剂（INSTI）治疗似乎对LF有保护作用：在这项研究中，每四名艾滋病病毒感染者中就有一人患有LS，而在有心血管风险因素的人群中，患病率上升到每两人中就有一人患有LS。LF的发病率较低，但对于CD4计数低或天门冬氨酸转氨酶水平高的老年HIV感染者来说，应考虑LF。INSTIs可能产生的保护作用值得进一步研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

HIV Medicine 医学-传染病学

CiteScore

5.10

自引率

10.00%

发文量

167

审稿时长

6-12 weeks

期刊介绍： HIV Medicine aims to provide an alternative outlet for publication of international research papers in the field of HIV Medicine, embracing clinical, pharmocological, epidemiological, ethical, preclinical and in vitro studies. In addition, the journal will commission reviews and other feature articles. It will focus on evidence-based medicine as the mainstay of successful management of HIV and AIDS. The journal is specifically aimed at researchers and clinicians with responsibility for treating HIV seropositive patients.