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Current HIV Research

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ISSN (Print): 1570-162X
ISSN (Online): 1873-4251

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Research Article

Detection of Non-Alcoholic Fatty Liver Disease with Non-invasive Tools in Turkish People Living with HIV and with Apparently Normal Liver Function

Author(s): Nursel Çalık Başaran*, İlkay İdilman, Hayriye Altunay Tokuçoğlu, Mehmet Ruhi Onur, Meliha Çağla Sönmezer, Lale Özışık, Muşturay Karçaaltıncaba, Ahmet Çağkan İnkaya and Serhat Ünal

Volume 21, Issue 3, 2023

Published on: 07 August, 2023

Page: [192 - 201] Pages: 10

DOI: 10.2174/1570162X21666230714122716

Price: $65

Abstract

Background: Non-alcoholic fatty liver disease (NAFLD) has become a significant cause of mortality and morbidity in people living with HIV.

Objective: We aimed to investigate NAFLD presence by magnetic resonance imaging (MRI) methods, including MRI-derived proton density fat fraction (MRI-PDFF) and MRE, and ultrasound elastography among Turkish people living with HIV (PLWH), and identify factors correlated with fatty liver.

Methods: We included 57 PLWH attending outpatient clinics on antiretroviral therapy (ART) for more than six months, without HBV/HCV co-infection, significant alcohol consumption, active opportunistic infection, previously diagnosed hepatobiliary disease, T2DM, and hyperlipidemia. We performed MRI, MRE, and US elastography on all participants.

Results: The mean age of the participants (M/F, 47/10) was 41.7± 12 years. The median duration of HIV infection was 3 (0.5-19 years) years. The mean MRI-PDFF was 4.4 ± 3.8 %, and 11 had fatty liver. The mean MRE value was 2.27 ± 0.6 kPa, inflammation was present in 16, and 4 participants had values consistent with fibrosis. The mean US elastography of the study population was 4.1±2.4 kPa. The mean right and left CCA intima-media of the study population was 0.65± 0.23 mm and 0.66± 0.25 mm; 16 had increased intima-media thickness. In patients with fatty liver, a significant positive correlation was present between MRE and CCA intima-media thickness (rs=0.82, p:0.006 for MRE-left CCA; r=0.68, p=0.042 for MRE-right CCA).

Conclusion: We demonstrated that even a significant proportion of PLWH individuals with normal transaminase levels have fatty liver. Future prospective trials are warranted to understand and mitigate the risk factors, course of NAFLD, and accurate non-invasive tests, predicting fibrosis in people living with HIV.

Keywords: HIV, PLWH, fatty liver, NAFLD, liver fibrosis, MR elastography, US elastography.

« Previous Next »
[1]
Eyawo O, Franco-Villalobos C, Hull MW, et al. Changes in mortality rates and causes of death in a population-based cohort of persons living with and without HIV from 1996 to 2012. BMC Infect Dis 2017; 17(1): 174-87.
[http://dx.doi.org/10.1186/s12879-017-2254-7] [PMID: 28241797]
[2]
Ratziu V, Bellentani S, Cortez-Pinto H, Day C, Marchesini G. A position statement on NAFLD/NASH based on the EASL 2009 special conference. J Hepatol 2010; 53(2): 372-84.
[http://dx.doi.org/10.1016/j.jhep.2010.04.008] [PMID: 20494470]
[3]
Sanyal AJ, Chalasani N, Kowdley KV, et al. Pioglitazone, vitamin E, or placebo for nonalcoholic steatohepatitis. N Engl J Med 2010; 362(18): 1675-85.
[http://dx.doi.org/10.1056/NEJMoa0907929] [PMID: 20427778]
[4]
Smith CJ, Ryom L, Weber R, et al. Trends in underlying causes of death in people with HIV from 1999 to 2011 (D:A:D): a multicohort collaboration. Lancet 2014; 384(9939): 241-8.
[http://dx.doi.org/10.1016/S0140-6736(14)60604-8] [PMID: 25042234]
[5]
Younossi ZM. Non-alcoholic fatty liver disease – A global public health perspective. J Hepatol 2019; 70(3): 531-44.
[http://dx.doi.org/10.1016/j.jhep.2018.10.033] [PMID: 30414863]
[6]
Maurice JB, Patel A, Scott AJ, Patel K, Thursz M, Lemoine M. Prevalence and risk factors of nonalcoholic fatty liver disease in HIV-monoinfection. AIDS 2017; 31(11): 1621-32.
[http://dx.doi.org/10.1097/QAD.0000000000001504] [PMID: 28398960]
[7]
Cervo A, Milic J, Mazzola G, Schepis F, Petta S, Krahn T, et al. Prevalence, predictors and severity of lean non-alcoholic fatty liver disease in HIV-infected patients. Clin Infect Dis 2020; 71(10): e694-701.
[http://dx.doi.org/10.1093/cid/ciaa430] [PMID: 32280969]
[8]
Vodkin I, Valasek MA, Bettencourt R, Cachay E, Loomba R. Clinical, biochemical and histological differences between HIV-associated NAFLD and primary NAFLD: a case-control study. Aliment Pharmacol Ther 2015; 41(4): 368-78.
[http://dx.doi.org/10.1111/apt.13052] [PMID: 25496369]
[9]
Kumar R, Priyadarshi RN, Anand U. Non-alcoholic fatty liver disease: Growing burden, adverse outcomes and associations. J Clin Transl Hepatol 2020; 8(1): 76-86.
[PMID: 32274348]
[10]
VanWagner LB, Rinella ME. Extrahepatic manifestations of nonalcoholic fatty liver disease. Curr Hepatol Rep 2016; 15(2): 75-85.
[http://dx.doi.org/10.1007/s11901-016-0295-9] [PMID: 27218012]
[11]
Buzzetti E, Pinzani M, Tsochatzis EA. The multiple-hit pathogenesis of non-alcoholic fatty liver disease (NAFLD). Metabolism 2016; 65(8): 1038-48.
[http://dx.doi.org/10.1016/j.metabol.2015.12.012] [PMID: 26823198]
[12]
Sulkowski MS, Mehta SH, Torbenson M, et al. Hepatic steatosis and antiretroviral drug use among adults coinfected with HIV and hepatitis C virus. AIDS 2005; 19(6): 585-92.
[http://dx.doi.org/10.1097/01.aids.0000163935.99401.25] [PMID: 15802977]
[13]
Lombardi R, Sambatakou H, Mariolis I, Cokkinos D, Papatheodoridis GV, Tsochatzis EA. Prevalence and predictors of liver steatosis and fibrosis in unselected patients with HIV mono-infection. Dig Liver Dis 2016; 48(12): 1471-7.
[http://dx.doi.org/10.1016/j.dld.2016.08.117] [PMID: 27623186]
[14]
Bakasis AD, Androutsakos T. Liver fibrosis during antiretroviral treatment in HIV-infected individuals. Truth or Tale? Cells 2021; 10(5): 1212.
[http://dx.doi.org/10.3390/cells10051212] [PMID: 34063534]
[15]
Cervo A, Shengir M, Patel K, Sebastiani G. NASH in HIV. Curr HIV/AIDS 2020; 17: 601-14.
[http://dx.doi.org/10.1007/s11904-020-00531-0]
[16]
Ando Y, Jou JH. Nonalcoholic fatty liver disease and recent guideline updates. Clin Liver Dis (Hoboken) 2021; 17(1): 23-8.
[http://dx.doi.org/10.1002/cld.1045] [PMID: 33552482]
[17]
European AIDS Clinical Society, Guidelines 11.0. 2021. Available from: https://www.eacsociety.org/media/final2021eacsguidelinesv11.0_oct2021.pdf (Accessed on: November 2021).
[18]
Grimby G, Börjesson M, Jonsdottir IH, Schnohr P, Thelle DS, Saltin B. The “Saltin-Grimby Physical Activity Level Scale” and its application to health research. Scand J Med Sci Sports 2015; 25 (Suppl. 4): 119-25.
[http://dx.doi.org/10.1111/sms.12611] [PMID: 26589125]
[19]
Kühn JP, Meffert P, Heske C, et al. Prevalence of fatty liver disease and hepatic iron overload in a northeastern german population by using quantitative MR imaging. Radiology 2017; 284(3): 706-16.
[http://dx.doi.org/10.1148/radiol.2017161228] [PMID: 28481195]
[20]
Idilman IS, Li J, Yin M, Venkatesh SK. MR elastography of liver: current status and future perspectives. Abdom Radiol (NY) 2020; 45(11): 3444-62.
[http://dx.doi.org/10.1007/s00261-020-02656-7] [PMID: 32705312]
[21]
Barr RG, Wilson SR, Rubens D, Garcia-Tsao G, Ferraioli G. Update to the society of radiologists in ultrasound liver elastography consensus statement. Radiology 2020; 296(2): 263-74.
[http://dx.doi.org/10.1148/radiol.2020192437] [PMID: 32515681]
[22]
Aminbakhsh A, Mancini GB. Carotid intima-media thickness measurements: what defines an abnormality? A systematic revi Barr RG, Wilson SR, Rubens D, Garcia-Tsao G, Ferraioli G.ew. Clin Invest Med 1999; 22(4): 149-57.
[PMID: 10497713]
[23]
Morse CG, McLaughlin M, Matthews L, et al. Nonalcoholic steatohepatitis and hepatic fibrosis in HIV-1-monoinfected adults with elevated aminotransferase levels on antiretroviral therapy. Clin Infect Dis 2015; 60(10): 1569-78.
[http://dx.doi.org/10.1093/cid/civ101] [PMID: 25681381]
[24]
Morse CG, McLaughlin M, Proschan M, et al. Transient elastography for the detection of hepatic fibrosis in HIV-monoinfected adults with elevated aminotransferases on antiretroviral therapy. AIDS 2015; 29(17): 2297-302.
[http://dx.doi.org/10.1097/QAD.0000000000000841] [PMID: 26544701]
[25]
Besutti G, Valenti L, Ligabue G, et al. Accuracy of imaging methods for steatohepatitis diagnosis in non‐alcoholic fatty liver disease patients: A systematic review. Liver Int 2019; 39(8): 1521-34.
[http://dx.doi.org/10.1111/liv.14118] [PMID: 30972903]
[26]
Lemoine M, Assoumou L, De Wit S, et al. Diagnostic accuracy of noninvasive markers of steatosis, NASH, and liver fibrosis in HIV-monoinfected individuals at risk of nonalcoholic fatty liver disease (NAFLD): Results from the ECHAM study. J Acquir Immune Defic Syndr 2019; 80(4): e86-94.
[http://dx.doi.org/10.1097/QAI.0000000000001936] [PMID: 30570529]
[27]
Xiao G, Zhu S, Xiao X, Yan L, Yang J, Wu G. Comparison of laboratory tests, ultrasound, or magnetic resonance elastography to detect fibrosis in patients with nonalcoholic fatty liver disease: A meta‐analysis. Hepatology 2017; 66(5): 1486-501.
[http://dx.doi.org/10.1002/hep.29302] [PMID: 28586172]
[28]
Kirkegaard-Klitbo DM, Bendtsen F, Lundgren J, Nielsen SD, Benfield T. Poor concordance between liver stiffness and noninvasive fibrosis scores in HIV infection without viral hepatitis. Clin Gastroenterol Hepatol 2019; 2019; S1542-3565(19): 31169.
[29]
Ding Y, Rao SX, Meng T, Chen C, Li R, Zeng MS. Usefulness of T1 mapping on Gd-EOB-DTPA-enhanced MR imaging in assessment of non-alcoholic fatty liver disease. Eur Radiol 2014; 24(4): 959-66.
[http://dx.doi.org/10.1007/s00330-014-3096-y] [PMID: 24463697]
[30]
Bischoff J, Gu W, Schwarze-Zander C, et al. Stratifying the risk of NAFLD in patients with HIV under combination antiretroviral therapy (cART). EClinicalMedicine 2021; 40: 101116.
[http://dx.doi.org/10.1016/j.eclinm.2021.101116] [PMID: 34522873]
[31]
Bourgi K, Jenkins CA, Rebeiro PF, et al. Weight gain among treatment‐naïve persons with HIV starting integrase inhibitors compared to non‐nucleoside reverse transcriptase inhibitors or protease inhibitors in a large observational cohort in the United States and Canada. J Int AIDS Soc 2020; 23(4): e25484.
[http://dx.doi.org/10.1002/jia2.25484] [PMID: 32294337]
[32]
Chrysavgis L, Ztriva E, Protopapas A, Tziomalos K, Cholongitas E. Nonalcoholic fatty liver disease in lean subjects: Prognosis, outcomes and management. World J Gastroenterol 2020; 26(42): 6514-28.
[http://dx.doi.org/10.3748/wjg.v26.i42.6514] [PMID: 33268944]

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