Prevalence, risk factors and liver-related complications of nonalcoholic fatty liver disease in Ethiopian HIV-infected patients: a cross-sectional study in a tertiary care center

Abstract

Background Ethiopia is one of the countries with high burden of HIV/AIDS. Although the number of fatalities from AIDS-defining illnesses has dramatically decreased, the incidence of non-AIDS defining comorbidities is increasing. Non-alcoholic fatty liver disease (NAFLD), in particular, continues to be one of the main causes of morbidity and mortality in this patient population. Though a few studies have tried to determine the prevalence of metabolic syndrome in Ethiopian patients with HIV infection, the frequency, risk factors, and potential liver-related outcomes of NAFLD among Ethiopian HIV patients have not been adequately studied. Method A cross-sectional study aimed at determining the prevalence, associated risk factors, and possible liver-related complications of NAFLD in Ethiopian HIV infected patients was conducted at the HIV clinic of Tikur Anbessa Specialized hospital from April 2020 to December 2020 G.C. A systematic random sampling method was used to recruit participants during their clinic visit. The final analysis included 110 patients, and the data was analyzed using SPSS version 26.0. Results The study found a 21.8% prevalence of NAFLD using ultrasound examination. 66.7% of participants with disease duration of more than 10 years had NAFLD; 83.3% of patients with NAFLD had a baseline CD4 count of less than 200; and 58.3% of patients had a BMI of ≥ 25 kg/m2. Liver fibrosis was detected in 5.4% patients using clinical the clinical scores, APRI and FIB-4. The study found significantly association between NAFLD and baseline CD4 count < 200 and BMI ≥ 25kg/m2 in HIV patients. Conclusions In comparison to earlier African research, the current study discovered a higher frequency of NAFLD in HIV patients from Ethiopia. Institutions and hospitals should provide better diagnostic techniques for the early diagnosis of steatosis and fibrosis in light of the worldwide rise in the prevalence of NAFLD.