期刊
HIV MEDICINE
卷 10, 期 1, 页码 53-59出版社
WILEY
DOI: 10.1111/j.1468-1293.2008.00651.x
关键词
chronic hepatitis C; fatty liver; HAART; HIV; liver fibrosis; transient elastometry; ultrasonography
资金
- Fundacion IES (Investigacion & Educacion en SIDA)
- Agencia Lain Entralgo
- Red de Investigacion en SIDA [ISCIII-RETIC RD06/006]
- European Commission
Objective Multiple factors may lead to hepatic steatosis (HS) in HIV-positive patients. HS may result in severe liver damage on its own and/or by accelerating the progression of chronic viral hepatitis B or C. Methods The sensitivity/specificity of liver ultrasound (US) to recognize severe IIS is above 85%. A cross-sectional case-control study of all HIV out-patients who underwent liver US since 2004 was conducted at our institution. Results Eight hundred and thirty (36.1%) out of 2300 HIV-positive patients on regular follow-up underwent liver US during the study period. Severe HS was diagnosed in 108 (13%) patients. A total of 117 matched HIV controls lacking HS were selected randomly. In patients with severe HS, we found significantly higher values of body mass index (BMI), plasma viral load, serum glucose, alkaline phosphatase, triglycerides and low-density lipoprotein cholesterol, as well as significantly higher prevalence of diabetes, elevated alcohol consumption, lipohypertrophy and advanced liver fibrosis. Furthermore, a trend towards longer exposure to nucleoside analogues was noticed. In the multivariate analysis, only elevated alcohol consumption [odds ratio (OR) 7, P = 0.013], lipohypertrophy (OR 5.3, P = 0.008), plasma viral load (OR 2.1, P = 0.02), BMI (OR 1.2, P = 0.013) and serum glucose (OR 1.03, P = 0.027) were significantly associated with severe HS. Conclusions Severe HS in HIV-positive patients is associated with predisposing factors that are similar to those of HIV-negative individuals. However, its characteristic association with elevated plasma viral load might suggest a direct involvement of HIV in liver fat deposition. Therefore, the benefit of controlling HIV replication with antiretroviral therapy should be balanced against its effect of occasionally inducing metabolic abnormalities and lipodystrophy.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据