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NASH, liver disease prevalent in patients with HIV-associated NAFLD
Patients with HIV-associated nonalcoholic fatty liver disease had more severe rates of liver disease and a higher prevalence of nonalcoholic steatohepatitis compared with patients with primary nonalcoholic fatty liver disease in a recent study.
“In this well-designed case-control study, we demonstrate that HIV-associated NAFLD is much more severe when compared to primary-NAFLD,” researcher Rohit Loomba, MD, MHSc, of the division of gastroenterology and epidemiology, University of California, San Diego, told Healio.com/Hepatology.
Rohit Loomba
Loomba and colleagues matched patients with primary NAFLD to patients with HIV-associated NAFLD by age and sex, using data drawn from a database of liver biopsies performed at the University of California, San Diego between 1999 and 2012. Overall, 4,525 liver biopsies were performed during the study period. Of these, 33 patients with primary NAFLD and 33 patients with HIV-associated NAFLD were included. The mean age of all patients was 44 years.
Patients with HIV-associated NAFLD had a higher mean aspartate aminotransferase vs. patients with primary NAFLD (88 IU/L vs. 41 U/L; P<.001), as well as higher mean alanine aminotransferase (146 U/L vs. 62 U/L; P<.001) and alkaline phosphatase (141 U/L vs. 75 U/L; P=.003).
Univariate analysis showed HIV-associated patients with NAFLD also were more likely to have definite steatohepatitis (62.7% vs. 36.4%; P=.027) and a higher mean NAFLD activity score (4.24 ± 1.5 vs. 3.33 ± 1.1; P=.006) compared with patients with primary NAFLD. APRI and FIB-4 noninvasive biomarker scores of advanced disease were greater among HIV patients; mean APRI was 1.2 vs. 0.5 (P<.001), and FIB-4 mean was 1.8 vs. 1.1 (P=.02) between groups.
“The study showed that the rates of [nonalcoholic steatohepatitis] are significantly increased in patients with HIV than the general population,” Loomba said. “Therefore, treatment strategies need to be explored in this subset of patients with NAFLD.” by – Melinda Stevens
Disclosure: The study was funded by Atlantic Philanthropies, the John A. Hartford Foundation, the Association of Specialty Professors, and the American Gastroenterological Association.