Prevalence and Related Risk Factors of Non-Alcoholic Fatty Liver Disease In HIV/AIDS Patients

Abstract

Objective: Non-alcoholic fatty liver disease (NAFLD) is the most common cause of fatty liver without inflammatory infiltration, excessive alcohol consumption, viral hepatitis, and other liver diseases. NAFLD is a major health problem as it can lead to cirrhosis, liver cancer and mortality. In HIV-positive patients, the prevalence of NAFLD ranges from 28 to 48%. Currently, there is no information about the prevalence and related factors related to NAFLD in those with HIV infection in our country. In this study, we aimed to investigate the prevalence of NAFLD and the related factors in newly diagnosed HIV-infected patients. Methods: The demographic data and ultrasonography of 558 HIV-infected patients newly diagnosed between June 2015 and September 2019 were analyzed retrospectively. In hepatic echogenicity, fatty liver was diagnosed with hyper echogenicity of liver compared with renal cortex and diffusion. Uni- and multi-variate logistic regression analyses were applied to estimate factors associated with NAFLD. Results: Of 358 patients who met the study criteria, 118 (33%) were diagnosed as NAFLD. Obesity was found in 10.2% of the patients with NAFLD and in 3.1% of the patients without NAFLD (p=0.021). NAFLD rate was significantly higher in patients with diabetes mellitus and hypertension (p<0.05). In the multivariate analysis, age, 1 mg/dl increase in glucose and triglyceride values and 1 unit increase in ALT/AST were associated with NAFLD. Conclusions: The results highlight the importance of early recognition and management of NAFLD and traditional factors associated with NAFLD in Turkish patients with HIV infection. Additionally, precautions and treatments should be a priority in the follow-up of patients in order to ensure the reduction of liver-related morbidity and mortality, which is one of the non-AIDS causes of these newly diagnosed HIV-infected patients.

Regional variation in NAFLD prevalence and risk factors among people living with HIV in Europe: a meta-analysis

“…After reviewing the full texts, a total of 36 studies met the inclusion criteria and were included in the final analysis ( 11 , 30–64 ) ( Figure 1 ). These studies were all from European countries, including the United Kingdom ( 42 , 46 ), France ( 31 , 35 , 38–40 , 64 ), Belgium ( 39 , 40 ), Greece ( 30 , 41 ), Italy ( 11 , 34 , 44 , 48 , 53 , 62 ), Spain ( 33 , 45 , 50 , 51 , 55 , 56 ), Denmark ( 36 ), Finland ( 37 , 57 ), Germany ( 32 , 39 , 40 , 43 , 49 , 58 , 63 ), Switzerland ( 54 ), Serbia ( 47 , 61 ), Austria ( 59 ), and Turkey ( 52 , 60 ) ( Supplementary Table S1 ). Most of the studies were cross-sectional in design, with a few prospective cohort studies.…”

“…Only one study focused on adolescents ( 64 ), while the rest were conducted on adults. Based on the geographical distribution of the study population across different European countries, they were categorized into Central Europe (CE) ( 32 , 43 , 49 , 54 , 58 , 59 , 63 ), Western Europe (WE) ( 31 , 35 , 38 , 42 , 46 , 64 ), Eastern Europe (EE) ( 47 , 52 , 60 , 61 ), Southern Europe (SE) ( 11 , 30 , 33 , 34 , 41 , 44 , 45 , 48 , 50 , 51 , 53 , 55 , 56 , 62 ), and Northern Europe (NE) ( 36 , 37 , 57 ). Two multicenter studies ( 39 , 40 ) included patients from Belgium, France, and Germany.…”

“…A total of 32 studies were analyzed, including 1 study ( 64 ) on adolescents and 31 studies ( 11 , 31–37 , 39–52 , 54–58 , 60–63 ) on adults. It involved 9,962 adults and 23 adolescents.…”

“…Data on risk factors for NAFLD in HIV mono-infected patients was obtained from fourteen studies ( 11 , 36 , 40–43 , 45–47 , 49 , 52 , 60 , 62 , 63 ) involving 7,444 individuals. Using these data, a meta-analysis was conducted on 18 variables ( Figures 7 – 9 ).…”