Fatty liver disease in children living with HIV: a ghostly iceberg

Carrasco, Itzíar; Olveira, Antonio; Lancharro, Ángel; Escosa, Luis; Mellado, María José; Busca, Carmen; Montes, María Luisa; Díez, Cristina; Alcolea-Ruiz, Sonia; Navarro, Marı́a Luisa; Sáinz, Talía

doi:10.1097/qad.0000000000003250

Cited by 2 publications

(2 citation statements)

References 8 publications

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“…The prevalence of hepatic steatosis in this longitudinal study (9%) is the same as observed in our cross-sectional study [7]. Cross sectional studies of liver disease in European and US PHIV children and youth found a higher prevalence of hepatic steatosis ranging from 17-33% [11,12,14]. Risk factors for hepatic steatosis were higher BMI or waist circumference, but not ART regimen, HIV viral suppression or other HIV-related factors.…”

Section: Statement Of Principal Findingssupporting

confidence: 81%

“…HIV-specific risk factors identified in adults include HIV viraemia, nucleoside reverse transcriptase inhibitor (NRTI) use and both increased or decreased CD4 counts, and may also be risk factors in children and adolescents with HIV [8][9][10]. In PHIV, the prevalence of MASLD ranges from 8 to 33% with identified risk factors being increased waist circumference, higher BMI and insulin resistance [11][12][13][14]. There is limited data available on MASLD in PHIV and no longitudinal data on changes over time.…”

Section: Introductionmentioning

confidence: 99%

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Longitudinal controlled attenuation parameter and liver stiffness in children with and without perinatal HIV infection in South Africa

Rose,

Davies,

Cotton

et al. 2024

Aids

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Objectives: Metabolic dysfunction-associated steatotic liver disease (MASLD) is an emerging cause of liver disease in HIV. Transient elastography (TE) with controlled attenuation parameter (CAP) measures liver stiffness as a marker of liver fibrosis and CAP as a measure of hepatic steatosis. Our aim was to evaluate longitudinal CAP and liver stiffness in children with perinatally acquired HIV (PHIV) on antiretroviral therapy (ART) from early life compared to HIV-uninfected children (HU). Design: Prospective cohort study Methods: PHIV and HU were followed annually for two years. During the study, 60% of PHIV switched from older ART regimens to tenofovir disoproxil, lamivudine and dolutegravir (TLD). Longitudinal evolution of CAP and liver stiffness were investigated in two PHIV groups - on older ART and on TLD - compared to HU children using linear mixed effects models. Results: 263 children and adolescents (112 PHIV, 151 HU) aged 7-20 years were followed. PHIV on older ART had CAP 8.61% (95% CI 4.42% to 12.97%, p < 0.001) greater than HU and no significant difference in CAP between PHIV on TLD and HU. No significant difference in liver stiffness was found between PHIV on older ART regimens and PHIV on TLD compared to HU. Conclusion: PHIV on older ART had higher CAP than HU, whereas in PHIV switched to TLD there was no difference in CAP compared to HU. There was no difference in liver stiffness between either PHIV group and HU. This suggests starting ART early in life might protect PHIV from developing hepatic fibrosis.

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