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

被引：3

作者：

Schwarz, Caroline ^{[1
,2
,3
]}

Chromy, David ^{[1
,2
,4
]}

Bauer, David ^{[1
,2
,3
]}

Duong, Nikki ^{[5
]}

Schmidbauer, Victor Ulrich ^{[6
]}

Schwarz, Michael ^{[1
,2
,3
]}

Mandorfer, Mattias ^{[1
,2
,7
]}

Rieger, Armin ^{[4
]}

Trauner, Michael ^{[1
,7
]}

Gschwantler, Michael ^{[3
,8
]}

Reiberger, Thomas ^{[1
,2
,7
]}

机构：

[1] Med Univ Vienna, Vienna Gen Hosp, Dept Med 3, Div Gastroenterol & Hepatol, Wahringer Gurtel 18-20,Red Tower, A-1090 Vienna, Austria

[2] Med Univ Vienna, Vienna HIV & Liver Study Grp, Vienna, Austria

[3] Klin Ottakring, Dept Internal Med 4, Vienna, Austria

[4] Med Univ Vienna, Dept Dermatol, Vienna, Austria

[5] Virginia Commonwealth Univ Med Ctr, Dept Gastroenterol & Hepatol, Richmond, VA USA

[6] Med Univ Vienna, Dept Biomed Imaging & Image Guided Therapy, Vienna, Austria

[7] Med Univ Vienna, Rare Liver Dis RALID, Ctr ERN RARE LIVER, Vienna, Austria

[8] Sigmund Freud Univ, Vienna, Austria

来源：

WIENER KLINISCHE WOCHENSCHRIFT | 2023年 / 135卷 / 15-16期

关键词：

Epidemiology; Metabolic dysfunction associated fatty liver disease; Human Immunodeficiency Virus; Protease Inhibitors; Non-alcoholic Fatty Liver Disease; FATTY LIVER-DISEASE; RISK-FACTORS;

D O I：

10.1007/s00508-022-02133-9

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background/aims 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. Methods 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). Results 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/mu L. 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 & GE; 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 & LE; 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. Conclusion 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.

引用

页码：420 / 428

页数：9

共 35 条

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