Hepatic Steatosis Is Associated with Fibrosis, Nucleoside Analogue Use, and Hepatitis C Virus Genotype 3 Infection in HIV‐Seropositive Patients

McGovern, Barbara; Ditelberg, Jeremy S.; Taylor, Lynn E.; Gandhi, Rajesh T.; Christopoulos, Katerina; Chapman, Stacey; Schwartzapfel, Beth; Rindler, Emily; Fiorino, Anne-Marie; Zaman, M. Tauheed; Sax, Paul E.; Graeme‐Cook, Fiona; Hibberd, Patricia L.

doi:10.1086/505495

Cited by 148 publications

(166 citation statements)

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“…There was no association between gender and the prevalence of HS in HIV/HCV-coinfected patients, either in individual studies or in the pooled data: pooled OR for female sex was 0.85, 95% CI 0.60-1.21, P ¼ 0.365, in 10 studies. [19][20][21][22]24,26,27,29,30 Similarly, HS prevalence was not different in African-American patients: pooled OR was 0.76, 95% CI 0.24-2.48, P ¼ 0.668, in two studies. 21,24 As verified in seven studies, [19][20][21][22]24,29,30 alcohol consumption was not associated with an increased risk of HS (pooled OR 0.95, 95% CI 0.70-1.30, P ¼ 0.761).…”

Section: Resultsmentioning

confidence: 86%

“…BMI, assessed in four studies, 22,23,25,26 was associated with an increased risk for HS; however, with small magnitude (pooled OR 1.13, 95% CI 1.07-1.19, P < 0.001) (Fig. 2).…”

Section: Resultsmentioning

confidence: 97%

“…Twelve studies were included [19][20][21][22][23][24][25][26][27][28][29][30] addressing a total of 1,989 HIV/HCV-coinfected patients. In four of these studies 20,24,25,28 data regarding HCV-monoinfected patients were presented separately, with a total of 1,540 patients.…”

Section: Resultsmentioning

confidence: 99%

“…In four of these studies 20,24,25,28 data regarding HCV-monoinfected patients were presented separately, with a total of 1,540 patients. Three studies had a retrospective recruitment 21,22,25 ; the remaining were prospective. HS was always evaluated by liver biopsy.…”

Section: Resultsmentioning

confidence: 99%

“…Regarding the presence of DM, seven studies [20][21][22]24,27,29,30 analyzed a possible association with increased risk for HS, although only two showed a significant association. 24,30 However, in the pooled data analysis there was a strong statistically significant association (pooled OR 2.32, 95% CI 1.32-4.07, P ¼ 0.003) (Fig.…”

Section: Resultsmentioning

confidence: 99%

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Hepatic Steatosis in Patients Coinfected with Human Immunodeficiency Virus/Hepatitis C Virus: A Meta-Analysis of the Risk Factors

2010

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Hepatic steatosis (HS) is frequent in patients with hepatitis C virus (HCV) infection, occurring in 40%-80%, associating with metabolic and virus-related factors, namely, genotype 3 and viral load. Human immunodeficiency virus (HIV) infection and antiretroviral treatment seem to be risk factors for HS. Several studies addressed this issue in coinfected patients, with discrepant results. A meta-analysis was performed on the HS risk factors in coinfected patients. Eligible studies were identified through structured keywords including coinfection, HCV, HIV, and steatosis in relevant databases including PubMed. Pooled odds ratios (ORs) and confidence limits (CIs) were obtained with the random-effects model and the DerSimonian-Laird method. Twelve studies, including 1,989 coinfected patients, were selected. Twenty percent were infected with HCV genotype 3. The overall prevalence of HS was 50.8% (23%-72%). Four studies also included 1,540 HCV monoinfected patients, not showing an increased risk for HS in coinfected patients (OR 1.61, 95% CI 0.84-3.10, P 5 0.151). In coinfected patients, HS was associated with higher body mass index (OR 1.13, 95% CI 1.07-1.19, P < 0.001), diabetes mellitus (OR 2.32, 95% CI 1.32-4.07, P 5 0.003), elevated alanine aminotransferase levels (OR 1.28, 95% CI 1.02-1.61, P 5 0.035), necroinflammatory activity (OR 1.72, 95% CI 1.11-2.67, P 5 0.016), and fibrosis (OR 1.67, 95% CI 1.20-2.34, P 5 0.003). No associations were found between HS and gender, other metabolic factors (dyslipidemia, glucose, metabolic syndrome), HCV-related factors (genotype, viral load), or HIV-related factors (viral load, CD4 count, antiretroviral therapy, and class of medication). Conclusion: In coinfected patients, HS does not seem to be more frequent than in HCV monoinfected patients and is mostly associated with metabolic factors, such as increased weight, diabetes mellitus, and more severe liver disease. The fact that no associations with HCV factors were found may be due to the small percentage of genotype 3-infected patients. (HEPATOLOGY 2010;52:71-78)

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Section: Resultsmentioning

confidence: 86%

“…BMI, assessed in four studies, 22,23,25,26 was associated with an increased risk for HS; however, with small magnitude (pooled OR 1.13, 95% CI 1.07-1.19, P < 0.001) (Fig. 2).…”

Section: Resultsmentioning

confidence: 97%