Author | Maurice, James B. | |
Author | Goldin, Robert | |
Author | Hall, Andrew | |
Author | Price, Jennifer C. | |
Author | Sebastiani, Giada | |
Author | Morse, Caryn G. | |
Author | Prat, Laura Iogna | |
Author | Perazzo, Hugo | |
Author | Garvey, Lucy | |
Author | Ingiliz, Patrick | |
Author | Guaraldi, Giovanni | |
Author | Tsochatzis, Emmanouil | |
Author | Lemoine, Maud | |
Access date | 2024-04-13T01:37:58Z | |
Available date | 2024-04-13T01:37:58Z | |
Document date | 2021 | |
Citation | MAURICE, James B. et al. 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. Clinical Infectious Diseases, v. 73, n. 7, p. 2184-2193, Oct. 2021. | en_US |
ISSN | 1058-4838 | en_US |
URI | https://www.arca.fiocruz.br/handle/icict/63491 | |
Description | Acknowledgments: The authors thank Jill Callard for her help in preparing the histology slides. | en_US |
Sponsorship | Financial support: The Department of Metabolism, Digestion and Reproduction at Imperial College London, receives funding from the National Institute of Health Research (NIHR) Biomedical Research Centre (BRC) based at Imperial College London and Imperial College Healthcare NHS Trust. H. P. has received funding support from Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)–Brazil—Universal 2016 (grant number 405.211/2016-3). G. S. is supported by a Junior 1 and 2 Salary Award from Fonds de Recherche Santé Québec (grant numbers 27127 and 267806) and research salary from the Department of Medicine of McGill University. J. C. P. has received support from the ACG Junior Faculty Development Award from the American College of Gastroenterology and UCSF Liver Center National Institute of Health (grant number P30 DK026743). | en_US |
Language | eng | en_US |
Publisher | Oxford University Press | en_US |
Rights | open access | en_US |
Title | 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 | en_US |
Type | Article | en_US |
DOI | 10.1093/cid/ciaa1302 | |
Abstract | 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. | en_US |
Affilliation | Imperial College London. St Mary's Hospital. Department of Metabolism, Digestion, and Reproduction. Section of Hepatology. London, United Kingdom / Royal Free Hospital NHS Trust. Department of Hepatology. London, United Kingdom. | en_US |
Affilliation | Imperial College Healthcare NHS Trust. Department of Histopathology. London, United Kingdom. | en_US |
Affilliation | Royal Free Hospital NHS Trust. Department of Histopathology. London, United Kingdom. | en_US |
Affilliation | University of California San Francisco. Department of Medicine. Division of Gastroenterology and Hepatology. San Francisco, California, USA. | en_US |
Affilliation | McGill University Health Centre. Chronic Viral Illness Service. Montreal, Quebec, Canada / McGill University Health Centre. Division of Gastroenterology and Hepatology. Montreal, Quebec, Canada. | en_US |
Affilliation | Wake Forest Baptist Medical Centre. Department of Infectious Disease. Winston-Salem, North Carolina, USA. | en_US |
Affilliation | Royal Free Hospital NHS Trust. Department of Hepatology. London, United Kingdom. | en_US |
Affilliation | Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Diseases. Rio de Janeiro, RJ, Brazil. | en_US |
Affilliation | Imperial College Healthcare NHS Trust. Department of Infectious Disease. London, United Kingdom. | en_US |
Affilliation | Charité University Medical Center. Department of Gastroenterology and Hepatology. Berlin, Germany. | en_US |
Affilliation | University of Modena and Reggio Emilia. Department of Surgical, Medical, Dental, and Morphological Sciences. Modena, Italy. | en_US |
Affilliation | Royal Free Hospital NHS Trust. Department of Hepatology. London, United Kingdom / University College London. Institute for Liver and Digestive Health. London, United Kingdom. | en_US |
Affilliation | Imperial College London. St Mary's Hospital. Department of Metabolism, Digestion, and Reproduction. Section of Hepatology. London, United Kingdom. | en_US |
Subject | NAFLD | en_US |
Subject | NASH | en_US |
Subject | Fibrosis | en_US |
Subject | HIV | en_US |
Subject | Histopathology | en_US |
e-ISSN | 1537-6591 | |