开始接受 DTG/ABC/3TC 与 BIC/FTC/TAF 抗逆转录病毒治疗的人类免疫缺陷病毒感染者在 48 周随访期间的非酒精性脂肪肝发病率比较。

IF 1.4 4区医学 Q4 IMMUNOLOGY International Journal of STD & AIDS Pub Date : 2024-09-27 DOI:10.1177/09564624241287886

Ana Luz Cano Díaz, Salma Triana González, Gloria Elizabeth Salinas Velázquez, José Antonio Mata Marín, Jesús Enrique Gaytán Martínez, Stefan Mauss

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引用次数: 0

摘要

目的：通过非侵入性方法确定艾滋病病毒感染者（PLWH）中非酒精性脂肪肝（NAFLD）的发病率：前瞻性队列研究：2021 年 2 月至 2023 年 8 月期间，在墨西哥城 "La Raza "传染病医院开始接受比特拉韦（BIC）或多替拉韦（DTG）治疗的初次接受抗逆转录病毒治疗的艾滋病病毒感染者。我们在基线和48周时测量了甘油三酯和葡萄糖指数（TyG）、脂肪肝指数（FLI）、肝脏脂肪变性指数（HSI）和肝脏超声波检查；确定了发生非酒精性脂肪肝的相对风险（RR）：48周时，BIC组的TyG指数为4.54（IQR为4.36-4.75），DTG组为4.66（IQR为4.49-4.80），P=0.080；BIC组的HSI为30.30（IQR为28.12-33.70），DTG组为30.85（IQR为28.02-34.50），P=0.650；BIC组的FLI为14.88 (IQR 7.91-31.80)，DTG 组为 19.49 (IQR 8.49-32.28)，P = .729；BIC 组中有 6 [10.3% (95%CI 4.8%-20.7%)] 人通过 US 检测出非酒精性脂肪肝，DTG 组中有 7 [10.9% (95%CI 6.4%-20.9%)] 人通过 US 检测出非酒精性脂肪肝，P = .916。非酒精性脂肪肝发生的风险因素是基线体重指数≥25 kg/m2，48周时基线高密度脂蛋白胆固醇为1.3：结论：在开始使用第二代 INSTI 48 周的 PLWH 中，非酒精性脂肪肝的发生率很高；基线超重、低 HDL- 胆固醇和治疗 48 周时 FIB-4 >1.3 是非酒精性脂肪肝发生的独立风险因素。

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Incidence of non-alcoholic fatty liver disease in antiretroviral therapy-naïve people with human immunodeficiency virus who start DTG/ABC/3TC compared to BIC/FTC/TAF at 48-week follow-up.

Purpose: To determine the incidence of non-alcoholic fatty liver disease (NAFLD) by non-invasive methods in people living with HIV (PLWH).

Methods: Prospective cohort, in PLWH naïve to antiretroviral therapy, starting bictegravir (BIC) or dolutegravir (DTG) at the Hospital de Infectología "La Raza", in Mexico City, from February 2021 to August 2023. We measured at baseline and 48 weeks triglycerides and glucose index (TyG), fatty liver index (FLI), hepatic steatosis index (HSI) and liver ultrasonography; relative risk (RR) for developing NAFLD was determined.

Results: At 48 weeks, TyG index in BIC-group 4.54 (IQR 4.36-4.75), in DTG-group 4.66 (IQR 4.49-4.80), p = .080; HSI in BIC-group 30.30 (IQR 28.12-33.70), in DTG-group 30.85 (IQR 28.02-34.50), p = .650; FLI in BIC-group 14.88 (IQR 7.91-31.80), in DTG-group 19.49 (IQR 8.49-32.28), p = .729; NAFLD was detected by US in 6 [10.3% (95%CI 4.8%-20.7%)] in BIC-group and, 7 [10.9% (95%CI 6.4%-20.9%)] in DTG-group, p = .916. Risk factors for NAFLD development were baseline BMI ≥25 kg/m², baseline HDL-c <40 mg/dL, and FIB-4 >1.3 at 48 weeks.

Conclusion: There is a high incidence of NAFLD in PLWH who start a second generation INSTI at 48 weeks; baseline overweight, low HDL-cholesterol and FIB-4 >1.3 at 48 weeks of treatment were independent risk factors for NAFLD development.

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来源期刊

International Journal of STD & AIDS 医学-传染病学

CiteScore

2.60

自引率

7.10%

发文量

144

审稿时长

3-6 weeks

期刊介绍： The International Journal of STD & AIDS provides a clinically oriented forum for investigating and treating sexually transmissible infections, HIV and AIDS. Publishing original research and practical papers, the journal contains in-depth review articles, short papers, case reports, audit reports, CPD papers and a lively correspondence column. This journal is a member of the Committee on Publication Ethics (COPE).