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HIV patients on ART exhibited reduced risk for fatty liver disease

Patients with HIV who received antiretroviral therapy were not at increased risk for fatty liver disease, according to recent study results.

In the cross-sectional Multicenter AIDS Cohort Study, researchers compared 465 men infected with HIV with 254 uninfected men. All participants were men who have sex with men and were recruited between 1984 and 1985, 1987 and 1990, and 2001 to 2003.

Researchers followed up with each patient every 6 months calling for an interview, examination, laboratory testing and collecting biological specimens. Ninety-two percent of infected men were receiving antiretroviral therapy (ART; median duration, 9 years), and 87% were treated with a nucleoside reverse transcriptase inhibitor (median duration, 8.5 years).

Fifteen percent of all participants were diagnosed with fatty liver and more common among uninfected vs. HIV-infected patients (19% vs. 13%; P=.02). Multivariate analysis indicated a significantly reduced risk for fatty liver among patients with HIV (OR=0.44; 95% CI, 0.26-0.74).

Factors independently associated with increased odds of fatty liver were abdominal visceral adipose tissue per 10 cm2 (OR=1.08; 95% CI, 1.04-1.11), PNPLA3 (rs738409) non-CC genotype (OR=2.06; 95% CI, 1.24-3.33), alanine aminotransferase greater than 40 U/I (OR=2.99; 95% CI, 1.65-5.42) and homeostatic model assessment of insulin resistance of at least 4.9 (OR=2.5; 95% CI, 1.44-4.36). Sensitivity analysis limited to patients without hepatitis C virus yielded similar results.

“We found that HIV-infected men had a higher frequency of factors commonly associated with fatty liver, but, unexpectedly, they had a lower prevalence of CT-defined fatty liver compared with the HIV-uninfected men,” the researchers wrote. “These findings may help clinicians identify HIV-infected patients who are at increased risk of developing fatty liver disease so that potentially modifiable fatty liver risk factors can be targeted for intervention.”

Disclosure: The researchers report no relevant financial disclosures.