TY - JOUR
T1 - Hepatic steatosis and nonalcoholic fatty liver disease are common and associated with cardiometabolic risk in a primary prevention cohort of people with HIV
AU - Lake, Jordan E.
AU - Taron, Jana
AU - Ribaudo, Heather J.
AU - Leon-Cruz, Jorge
AU - Utay, Netanya S.
AU - Swaminathan, Shobha
AU - Fitch, Kathleen V.
AU - Kileel, Emma M.
AU - Paradis, Kayla
AU - Fulda, Evelynne S.
AU - Ho, Ken S.
AU - Luetkemeyer, Anne F.
AU - Johnston, Carrie D.
AU - Zanni, Markella V.
AU - Douglas, Pamela S.
AU - Grinspoon, Steven K.
AU - Lu, Michael T.
AU - Fichtenbaum, Carl J.
N1 - Publisher Copyright:
© 2023 Lippincott Williams and Wilkins. All rights reserved.
PY - 2023/11/15
Y1 - 2023/11/15
N2 - Background:Hepatic steatosis, including nonalcoholic fatty liver disease (NAFLD), is common among people with HIV (PWH). We present baseline steatosis prevalence and cardiometabolic characteristics among REPRIEVE substudy participants.Methods:REPRIEVE is an international, primary cardiovascular disease prevention, randomized, controlled trial of pitavastatin calcium vs. placebo among 7769 PWH ages 40-75years on antiretroviral therapy (ART) and with low-To-moderate cardiovascular risk. A subset of participants underwent noncontrast computed tomography, with hepatic steatosis defined as mean hepatic attenuation less than 40 HU or liver/spleen ratio less than 1.0, and NAFLD defined as steatosis in the absence of frequent alcohol use or viral hepatitis.Results:Of 687 evaluable persons, median age was 51years, BMI 27kg/m2, CD4+T-cell count 607 cells/μl; 17% natal female sex, 36% Black, 24% Hispanic, and 98% HIV-1 RNA less than 400copies/ml. Hepatic steatosis prevalence was 22% (149/687), and NAFLD 21% (96/466). Steatosis/NAFLD prevalence was higher in men and with older age, non-Black race, and higher BMI and waist circumference. Both were associated with BMI greater than 30kg/m2, metabolic syndrome components, higher atherosclerotic cardiovascular disease (ASCVD) risk score, HOMA-IR, LpPLA-2 and hs-CRP, and lower high-density lipoprotein cholesterol. Of HIV-specific/ART-specific characteristics, only history of an AIDS-defining illness was more common among persons with steatosis/NAFLD. After adjusting for age, sex and race/ethnicity, BMI greater than 30kg/m2, HOMA-IR greater than 2.0, Metabolic syndrome and each of its components were associated with NAFLD prevalence.Conclusion:In this cohort with controlled HIV and low-To-moderate cardiovascular risk, hepatic steatosis and NAFLD were common and associated with clinically relevant metabolic and inflammatory disturbances but not current HIV-related or ART-related factors.
AB - Background:Hepatic steatosis, including nonalcoholic fatty liver disease (NAFLD), is common among people with HIV (PWH). We present baseline steatosis prevalence and cardiometabolic characteristics among REPRIEVE substudy participants.Methods:REPRIEVE is an international, primary cardiovascular disease prevention, randomized, controlled trial of pitavastatin calcium vs. placebo among 7769 PWH ages 40-75years on antiretroviral therapy (ART) and with low-To-moderate cardiovascular risk. A subset of participants underwent noncontrast computed tomography, with hepatic steatosis defined as mean hepatic attenuation less than 40 HU or liver/spleen ratio less than 1.0, and NAFLD defined as steatosis in the absence of frequent alcohol use or viral hepatitis.Results:Of 687 evaluable persons, median age was 51years, BMI 27kg/m2, CD4+T-cell count 607 cells/μl; 17% natal female sex, 36% Black, 24% Hispanic, and 98% HIV-1 RNA less than 400copies/ml. Hepatic steatosis prevalence was 22% (149/687), and NAFLD 21% (96/466). Steatosis/NAFLD prevalence was higher in men and with older age, non-Black race, and higher BMI and waist circumference. Both were associated with BMI greater than 30kg/m2, metabolic syndrome components, higher atherosclerotic cardiovascular disease (ASCVD) risk score, HOMA-IR, LpPLA-2 and hs-CRP, and lower high-density lipoprotein cholesterol. Of HIV-specific/ART-specific characteristics, only history of an AIDS-defining illness was more common among persons with steatosis/NAFLD. After adjusting for age, sex and race/ethnicity, BMI greater than 30kg/m2, HOMA-IR greater than 2.0, Metabolic syndrome and each of its components were associated with NAFLD prevalence.Conclusion:In this cohort with controlled HIV and low-To-moderate cardiovascular risk, hepatic steatosis and NAFLD were common and associated with clinically relevant metabolic and inflammatory disturbances but not current HIV-related or ART-related factors.
KW - HIV
KW - hepatic steatosis
KW - nonalcoholic fatty liver disease
UR - https://www.scopus.com/pages/publications/85175269332
UR - https://www.scopus.com/pages/publications/85175269332#tab=citedBy
U2 - 10.1097/QAD.0000000000003671
DO - 10.1097/QAD.0000000000003671
M3 - Article
C2 - 37503623
AN - SCOPUS:85175269332
SN - 0269-9370
VL - 37
SP - 2149
EP - 2159
JO - AIDS
JF - AIDS
IS - 14
ER -