Liver Steatosis in Chinese HIV-infected Patients with Hypertriglyceridemia: Characteristics and Independent Risk Factors

Overview

Journal Virol J

Publisher Biomed Central

Specialty Microbiology

Date 2013 Aug 15

PMID 23941464

Citations 1

Authors

Jiang Xiao

Ning Han

Di Yang

Hongxin Zhao

Affiliations

Soon will be listed here.

Abstract

Background: Since Highly Active Antiretroviral Therapy (HAART) medications were made available in 2002, multiple serious side effects have been observed. However, no study has yet systematically evaluated the prevalence of liver steatosis, a very serious but treatable side effect.

Objectives: This study examined the prevalence of and independent risk factors for liver steatosis in Chinese HIV-infected, HAART-experienced patients who had been diagnosed with hypertriglyceridemia.

Methods: In this cross-sectional observational study, the prevalence of liver steatosis was determined by ultrasound imaging that detected diffusion in hepatic echogenicity. The risk factors associated with steatosis were evaluated with a proportional odds logistic regression model.

Results: Among 163 HIV-infected patients with hypertriglyceridemia and past HAART experience, 75(46%) patients were determined to have liver steatosis. In multivariable logistic regression model, the risk factors associated with liver steatosis were: higher triglyceride level (OR = 1.086, P = 0.026), metabolic syndromes (OR = 2.092, P = 0.024) and exposure to nucleoside reverse transcriptase inhibitor (NRTIs) ((OR = 2.11, P = 0.001) and Stavudine (OR = 3.75, P = 0.01)). Exposure to Nevirapine (OR = 0 .41, P = 0.003) was a favorable factor for lipid metabolism in vivo and was a protective factors for liver steatosis.

Conclusions: Chinese HIV-infected patients with hypertriglyceridemia appear to be prone to liver steatosis, especially those on NRTIs. Routine screening should be considered on their lipid panels.

Citing Articles

Metabolic causes of liver disease among adults living with HIV from low- and middle-income countries: a cross-sectional study.

Plaisy M, Minga A, Wandeler G, Murenzi G, Samala N, Ross J J Int AIDS Soc. 2024; 27(4):e26238.

PMID: 38566493 PMC: 10988113. DOI: 10.1002/jia2.26238.

References

Koller T, Kollerova J, Hlavaty T, Huorka M, Payer J . Cholelithiasis and markers of nonalcoholic fatty liver disease in patients with metabolic risk factors. Scand J Gastroenterol. 2011; 47(2):197-203. DOI: 10.3109/00365521.2011.643481. View

Mohammed S, Aghdassi E, Salit I, Avand G, Sherman M, Guindi M . HIV-positive patients with nonalcoholic fatty liver disease have a lower body mass index and are more physically active than HIV-negative patients. J Acquir Immune Defic Syndr. 2007; 45(4):432-8. DOI: 10.1097/QAI.0b013e318074efe3. View

Jevtovic D, Dragovic G, Salemovic D, Ranin J, Djurkovic-Djakovic O . The metabolic syndrome, an epidemic among HIV-infected patients on HAART. Biomed Pharmacother. 2008; 63(5):337-42. DOI: 10.1016/j.biopha.2008.09.011. View

Jerico C, Knobel H, Montero M, Ordonez-Llanos J, Guelar A, Gimeno J . Metabolic syndrome among HIV-infected patients: prevalence, characteristics, and related factors. Diabetes Care. 2004; 28(1):132-7. DOI: 10.2337/diacare.28.1.132. View

Pol S, Lebray P, Vallet-Pichard A . HIV infection and hepatic enzyme abnormalities: intricacies of the pathogenic mechanisms. Clin Infect Dis. 2004; 38 Suppl 2:S65-72. DOI: 10.1086/381499. View

Browning J, Szczepaniak L, Dobbins R, Nuremberg P, Horton J, Cohen J . Prevalence of hepatic steatosis in an urban population in the United States: impact of ethnicity. Hepatology. 2004; 40(6):1387-95. DOI: 10.1002/hep.20466. View

Guaraldi G, Squillace N, Stentarelli C, Orlando G, DAmico R, Ligabue G . Nonalcoholic fatty liver disease in HIV-infected patients referred to a metabolic clinic: prevalence, characteristics, and predictors. Clin Infect Dis. 2008; 47(2):250-7. DOI: 10.1086/589294. View

Castera L, Loko M, Le Bail B, Coffie P, de Ledinghen V, Trimoulet P . Hepatic steatosis in HIV-HCV coinfected patients in France: comparison with HCV monoinfected patients matched for body mass index and HCV genotype. Aliment Pharmacol Ther. 2007; 26(11-12):1489-98. DOI: 10.1111/j.1365-2036.2007.03533.x. View

van der Valk M, Kastelein J, Murphy R, van Leth F, Katlama C, Horban A . Nevirapine-containing antiretroviral therapy in HIV-1 infected patients results in an anti-atherogenic lipid profile. AIDS. 2001; 15(18):2407-14. DOI: 10.1097/00002030-200112070-00008. View

10.

Zhang F, Haberer J, Wang Y, Zhao Y, Ma Y, Zhao D . The Chinese free antiretroviral treatment program: challenges and responses. AIDS. 2008; 21 Suppl 8:S143-8. DOI: 10.1097/01.aids.0000304710.10036.2b. View

11.

Bedogni G, Miglioli L, Masutti F, Tiribelli C, Marchesini G, Bellentani S . Prevalence of and risk factors for nonalcoholic fatty liver disease: the Dionysos nutrition and liver study. Hepatology. 2005; 42(1):44-52. DOI: 10.1002/hep.20734. View

12.

Lesi O, Soyebi K, Eboh C . Fatty liver and hyperlipidemia in a cohort of HIV-positive Africans on highly active antiretroviral therapy. J Natl Med Assoc. 2009; 101(2):151-5. DOI: 10.1016/s0027-9684(15)30828-2. View

13.

Farrell G, Larter C . Nonalcoholic fatty liver disease: from steatosis to cirrhosis. Hepatology. 2006; 43(2 Suppl 1):S99-S112. DOI: 10.1002/hep.20973. View

14.

De Luca A, Cozzi-Lepri A, Antinori A, Zaccarelli M, Bongiovanni M, Di Giambenedetto S . Lopinavir/ritonavir or efavirenz plus two nucleoside analogues as first-line antiretroviral therapy: a non-randomized comparison. Antivir Ther. 2006; 11(5):609-18. View

15.

Parienti J, Massari V, Rey D, Poubeau P, Verdon R . Efavirenz to nevirapine switch in HIV-1-infected patients with dyslipidemia: a randomized, controlled study. Clin Infect Dis. 2007; 45(2):263-6. DOI: 10.1086/518973. View

16.

van Leth F, Hall D, Lange J, Reiss P . Plasma lipid concentrations after 1.5 years of exposure to nevirapine or efavirenz together with stavudine and lamivudine. HIV Med. 2006; 7(6):347-50. DOI: 10.1111/j.1468-1293.2006.00390.x. View

17.

Brown T, Li X, Cole S, Kingsley L, Palella F, Riddler S . Cumulative exposure to nucleoside analogue reverse transcriptase inhibitors is associated with insulin resistance markers in the Multicenter AIDS Cohort Study. AIDS. 2005; 19(13):1375-83. DOI: 10.1097/01.aids.0000181011.62385.91. View

18.

Neuschwander-Tetri B, Caldwell S . Nonalcoholic steatohepatitis: summary of an AASLD Single Topic Conference. Hepatology. 2003; 37(5):1202-19. DOI: 10.1053/jhep.2003.50193. View

19.

Adams L, Lymp J, Sauver J, Sanderson S, Lindor K, Feldstein A . The natural history of nonalcoholic fatty liver disease: a population-based cohort study. Gastroenterology. 2005; 129(1):113-21. DOI: 10.1053/j.gastro.2005.04.014. View

20.

Fan J, Zhu J, Li X, Chen L, Li L, Dai F . Prevalence of and risk factors for fatty liver in a general population of Shanghai, China. J Hepatol. 2005; 43(3):508-14. DOI: 10.1016/j.jhep.2005.02.042. View