期刊
JOURNAL OF THE INTERNATIONAL AIDS SOCIETY
卷 21, 期 11, 页码 -出版社
JOHN WILEY & SONS LTD
DOI: 10.1002/jia2.25201
关键词
liver disease; hepatic fibrosis; fatty liver; HIV infection; HIV care continuum
资金
- International Society for Infectious Diseases (ISID Research Grant 2016)
- Fundacao Carlos Chagas Filho de Amparo a Pesquisa do Estado do Rio de Janeiro [E-26/110.268/2014]
- Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq) - Universal 2016 [405.211/2016-3]
- Programa Ciencias Sem Fronteiras -Bolsa Jovens Talentos/CNPq [407.410/2013-9, 301.520/2014-3]
Introduction Non-alcoholic fatty liver disease is characterized by the presence of hepatic steatosis and can be associated with fibrosis progression, development of cirrhosis and liver-related complications. Data on the prevalence of liver fibrosis and steatosis in HIV patients remain contradictory in resource-limited settings. We aimed to describe the prevalence and factors associated with liver fibrosis and steatosis in patients with HIV mono-infection under long-term antiretroviral therapy (ART) in Rio de Janeiro, Brazil. MethodsResultsClinical assessment, fasting blood collection and liver stiffness measurement (LSM)/controlled attenuation parameter (CAP) by transient elastography were performed on the same day for this cross-sectional study (PROSPEC-HIV study; NCT02542020). Patients with viral hepatitis co-infection, ART-naive or missing data were excluded. Liver fibrosis and steatosis were defined by LSM8.0kPa and CAP248dB/m respectively. HIV history, cumulative and current ART regimens were evaluated. Multivariate logistic regression models adjusted for age and gender were performed. In total, 395 patients (60% female; median age of 45 (IQR, 35 to 52) years, body mass index=25.7 (23.2 to 29.4) kg/m(2), alanine aminotransferase=30 (23 to 42) IU/L, duration of ART for 7 (4 to 14) years) were included. LSM and CAP were reliable in 93% (n=367) and 87% (n=344) respectively. The prevalence of fibrosis and steatosis were 9% (95% confidence interval (CI), 7 to 13) and 35% (95% CI, 30 to 40) respectively. The following factors were associated with fibrosis (odds ratio (OR) (95% CI)): older age (per 10years; 1.80 (1.27 to 2.55); p=0.001) and CD4+ count <200cells/mm(3) (7.80 (2.09 to 29.09), p=0.002). Type 2 diabetes had a trend towards the presence of liver fibrosis (2.67 (0.96 to 7.46), p=0.061). Central obesity (10.74 (4.40 to 26.20), p<0.001), type 2 diabetes (9.74 (3.15 to 30.10), p<0.001), dyslipidaemia (2.61 (1.35 to 5.05), p=0.003) and metabolic syndrome (4.28 (2.45 to 7.46), p<0.001) were associated with steatosis. A dominant backbone ART regimen of zidovudine (AZT), d4T, ddI or ddC was associated with steatosis (1.90 (1.07 to 3.38), p=0.028) independently of metabolic features. ConclusionIntegrated strategies for preventing non-communicable diseases in people with HIV mono-infection are necessary to decrease the burden of liver diseases. Clinical Trial Number: NCT02542020.
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