 |
|
|
| |
Global prevalence of liver impairment in HIV population in direct
antiviral agents (DAA) era: the role of fatty liver disease
|
| |
| |
Download the PDF here
NAFLD is associated with duration of antiretroviral exposure and age. In 79 (21%) some grade of NAFLD was described in abdominal US
We found persistently abnormal high transaminase levels in 108 patients (28,9%), which was significantly associated with male gender [OR (IC95%), 2,1(1,1-3,9)] and having fatty liver in US [OR (IC95%), 2,1(1,2-3,2)]. We found significant association with abdominal ultrasound fatty liver and the duration of antiretroviral treatment exposure (p=0,005) and age (p< 0,001).
J. Diaz-Alvarez1, P. Roiz1, M.J. Vivancos1, A. Moreno1, M. Rosas1,
G. Starita1, S. Serrano1, C. Quereda1, M.J. Pérez-Elias1, S. Moreno1,
M. Sanchez-Conde2
1Hospital Universitario Ramón y Cajal, Madrid, Spain, 2Hospital
Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
EACS 2019 Nov 6-9 Basel
Reported by Jules Levin
J. Diaz-Alvarez1, P. Roiz1, M.J. Vivancos1, A. Moreno1, M. Rosas1, G. Starita1, S. Serrano1, C. Quereda1, M.J. Pérez-Elias1, S. Moreno1, M. Sanchez-Conde2
1Hospital Universitario Ramón y Cajal, Madrid, Spain, 2Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
Abstract
Purpose: Our objectives are to analyze the global prevalence and causes of hepatic impairment in the HIV-infected population and to know the role of NAFLD in this population
Methods: Cross-sectional study was conducted in our HIV outpatient clinic between March and May 2017. Sociodemographic, clinical, analytical, and abdominal ultrasound (US) performed in the 24 previous months were collected.
Results: 373 consecutive HIV-infected patients were included. Median age 50 (IQR 42-55); 75,1% men, median CD4 691 cells/mm3 (IQR 468-891). Undetectable HIV viral load in 89,8%.
Hepatic impairment triggers were: HCV (+) 146 (39%) 82 of them already cured with DAAs, AgVHBs(+) 3,7%. We found persistently abnormal high transaminase levels in 108 patients (28,9%), which was significantly associated with male gender [OR (IC95%), 2,1(1,1-3,9)] and having fatty liver in US [OR (IC95%), 2,1(1,2-3,2)].
In 79 (21%) some grade of NAFLD was described in abdominal US. We managed to identify the underlying cause of liver impairment in 59/108 patients, albeit it remains unclear in 49/108 (13,1 % of the whole population). We found significant association with abdominal ultrasound fatty liver and the duration of antiretroviral treatment exposure (p=0,005) and age (p< 0,001)
Conclusion: Even though 1/3 of the HIV-infected population has persistently elevated transaminases, in 13% of them, the cause remains unclear. Taking into account that fatty liver is described in 21% of this population, we must consider NAFLD of paramount importance in this population. NAFLD is associated with duration of antiretroviral exposure and age. We need further research that will allow us to understand this emerging problem in the HIV-infected subjects.
|
| |
|
|
|
|
|
