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Hepatic steatosis progresses faster in HIV mono-infected than HIV/HCV co-infected patients and is associated with liver fibrosis

Pembroke, Thomas ORCID: https://orcid.org/0000-0002-2600-2034, Deschenes, Marc, Lebouché, Bertrand, Benmassaoud, Amine, Sewitch, Maida, Ghali, Peter, Wong, Philip, Halme, Alex, Vuille-Lessard, Elise, Pexos, Costa, Klein, Marina B. and Sebastiani, Giada 2017. Hepatic steatosis progresses faster in HIV mono-infected than HIV/HCV co-infected patients and is associated with liver fibrosis. Journal of Hepatology 67 (4) , pp. 801-808. 10.1016/j.jhep.2017.05.011

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Abstract

Background & Aims Hepatic steatosis (HS) seems common in patients infected with human immunodeficiency virus (HIV). However, the relative effect of HIV, as well as hepatitis C virus (HCV) in those co-infected, and the influence of HS on liver fibrosis progression are unclear. Methods The LIVEr disease in HIV (LIVEHIV) is a Canadian prospective Cohort using transient elastography and associated controlled attenuation parameter (CAP) to screen for HS and liver fibrosis in unselected HIV-infected adults. HS progression was defined as development of any grade HS (CAP ≥248 dB/m), or transition to severe HS (CAP ≥292 dB/m) for those with any grade HS at baseline. Fibrosis progression was defined as development of significant liver fibrosis (liver stiffness measurement [LSM] ≥7.1kPa), or transition to cirrhosis (LSM ≥12.5kPa) for those with significant liver fibrosis at baseline. Cox regression analysis was used to assess predictors of HS and fibrosis progression. Results A prospective cohort study was conducted, which included 726 HIV-infected patients (22.7% HCV co-infected). Prevalence of any grade HS did not differ between HIV mono-infected and HIV/HCV co-infected patients (36.1% vs 38.6%, respectively). 313 patients were followed for a median of 15.4 (interquartile range 8.5-23.0) months. The rate of HS progression was 37.8 (95% confidence interval [CI] 29.2-49.0) and 21.9 (95% CI 15.6-30.7) per 100 person-years in HIV mono-infection and HIV/HCV co-infection, respectively. HCV co-infection was an independent negative predictor of HS progression (adjusted hazard ratio [aHR] 0.50, 95% CI 0.28-0.89). HS predicted liver fibrosis progression in HIV mono-infection (aHR 4.18, 95% CI 1.21-14.5), but not in HIV/HCV co-infection. Conclusion HS progresses faster and is associated with liver fibrosis progression in HIV mono-infection but not in HIV/HCV co-infection.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Subjects: R Medicine > R Medicine (General)
Uncontrolled Keywords: HIV mono-infection; HIV/HCV co-infection; hepatic steatosis; liver fibrosis; transient elastography; liver stiffness; controlled attenuation parameter; prevalence; incidence.
Publisher: Elsevier
ISSN: 0168-8278
Date of First Compliant Deposit: 23 May 2017
Date of Acceptance: 10 May 2017
Last Modified: 07 Nov 2023 06:16
URI: https://orca.cardiff.ac.uk/id/eprint/100795

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