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Increased Body Mass Index and Type 2 Diabetes Are the Main Predictors of Nonalcoholic Fatty Liver Disease and Advanced Fibrosis in Liver Biopsies of Patients With Human Immunodeficiency Virus Monoinfection.
Maurice, James B; Goldin, Robert; Hall, Andrew; Price, Jennifer C; Sebastiani, Giada; Morse, Caryn G; Prat, Laura Iogna; Perazzo, Hugo; Garvey, Lucy; Ingiliz, Patrick; Guaraldi, Giovanni; Tsochatzis, Emmanouil; Lemoine, Maud.
Afiliación
  • Maurice JB; Department of Metabolism, Digestion, and Reproduction, Section of Hepatology, St Mary's Hospital, Imperial College London, London, United Kingdom.
  • Goldin R; Department of Hepatology, Royal Free Hospital NHS Trust, London, United Kingdom.
  • Hall A; Department of Histopathology, Imperial College Healthcare NHS Trust, London, United Kingdom.
  • Price JC; Department of Histopathology, Royal Free Hospital NHS Trust, London, United Kingdom.
  • Sebastiani G; Division of Gastroenterology and Hepatology, Department of Medicine, University of California San Francisco, San Francisco, California, USA.
  • Morse CG; Chronic Viral Illness Service, McGill University Health Centre (MUHC), Montreal, Quebec, Canada.
  • Prat LI; Division of Gastroenterology and Hepatology, MUHC, Montreal, Quebec, Canada.
  • Perazzo H; Department of Infectious Disease, Wake Forest Baptist Medical Centre, Winston-Salem, North Carolina, USA.
  • Garvey L; Department of Hepatology, Royal Free Hospital NHS Trust, London, United Kingdom.
  • Ingiliz P; National Institute of Infectious Diseases Evandro Chagas, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil.
  • Guaraldi G; Department of Infectious Disease, Imperial College Healthcare NHS Trust, London, United Kingdom.
  • Tsochatzis E; Department of Gastroenterology and Hepatology, Charité University Medical Center, Berlin, Germany.
  • Lemoine M; Department of Surgical, Medical, Dental, and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy.
Clin Infect Dis ; 73(7): e2184-e2193, 2021 10 05.
Article en En | MEDLINE | ID: mdl-32877569
BACKGROUND: Liver disease is an important cause of morbidity and mortality in people living with human immunodeficiency virus (PLWH), of which nonalcoholic fatty liver disease (NAFLD) is an increasingly recognized cause. There are limited data investigating NAFLD in HIV monoinfection and histologically defined disease. We aimed to identify who is at risk of fibrosis, NAFLD, and nonalcoholic steatohepatitis (NASH) among PLWH and explore the diagnostic accuracy of noninvasive markers of fibrosis. METHODS: This was a retrospective, cross-sectional, international, multicenter study including patients with HIV monoinfection, without chronic viral hepatitis or other known causes of chronic liver disease, who underwent liver biopsy for abnormal liver biochemistry and/or clinical suspicion of liver fibrosis. RESULTS: A total of 116 patients from 5 centers were included. Sixty-three (54%) had NAFLD, of whom 57 (92%) had NASH. Overall, 36 (31%) had advanced fibrosis (≥F3) and 3 (3%) had cirrhosis. Of the 53 cases without NAFLD, 15 (28%) had advanced fibrosis. Collagen proportionate area was similar between cases with and without NAFLD (3% vs 2%). Body mass index was independently associated with NAFLD (aOR, 1.2; 95% CI, 1.08-1.34), and type 2 diabetes was independently associated with advanced fibrosis (aOR, 3.42; 95% CI, 1.00-11.71). The area under the curve for advanced fibrosis was 0.65 and 0.66 for both NAFLD Fibrosis Score (NFS) and FIB-4. Cutoff values of -1.455 (NFS) and 1.3 (FIB-4) have negative-predictive values of 0.80 and 0.82, respectively. CONCLUSIONS: Advanced fibrosis is strongly associated with type 2 diabetes in PLWH. Serological markers require further optimization.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones por VIH / Diabetes Mellitus Tipo 2 / Enfermedad del Hígado Graso no Alcohólico Tipo de estudio: Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Clin Infect Dis Asunto de la revista: DOENCAS TRANSMISSIVEIS Año: 2021 Tipo del documento: Article País de afiliación: Reino Unido Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones por VIH / Diabetes Mellitus Tipo 2 / Enfermedad del Hígado Graso no Alcohólico Tipo de estudio: Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Clin Infect Dis Asunto de la revista: DOENCAS TRANSMISSIVEIS Año: 2021 Tipo del documento: Article País de afiliación: Reino Unido Pais de publicación: Estados Unidos