Among people with HIV who do not have viral hepatitis, having a higher body mass index (BMI) is associated with a greater risk of non-alcoholic fatty liver disease (NAFLD), and having type 2 diabetes is tied to a higher risk of advanced liver damage, aidsmap reports.
Researchers at hospitals in the United Kingdom, Italy, Canada and the United States conducted a retrospective study of liver biopsy samples from 116 people with HIV. All these individuals had experienced unexplained increases in their liver enzymes or other abnormal results in their lab tests that suggested they might have liver disease. The study, which was published in Clinical Infectious Diseases, spanned 2001 to 2019.
The study excluded people with hepatitis B or C viruses and cancer and those who drank to excess (more than 21 weekly drinks for men and 14 weekly drinks for women) or who had any other major cause of liver disease.
The cohort members had a median age of 48 years old. Ninety-three percent were men, 72% were white and the median amount of time they had been on antiretroviral treatment was nine years. The median CD4 count was 638, and the median BMI was 29 (25 to 29.9 is overweight; 30 or above is obese). Fifty-three percent of the participants had high blood pressure, and 25% had diabetes.
Biopsies indicated that 54% of the participants had NAFLD, and 49% had the disease’s more severe form, non-alcoholic steatohepatitis (NASH). Over time, fat accumulation in the liver can lead to fibrosis (scarring) of the liver, cirrhosis (severe scarring) and liver cancer. Thirty-one percent had advanced fibrosis, and 2% had cirrhosis.
After adjusting the data to account for various differences between the participants in metabolic factors associated with fatty liver disease or HIV-related factors, the study authors found that having a higher BMI was associated with a 20% greater likelihood of having NAFLD. Having type 2 diabetes was associated with a 3.42-fold increased likelihood of having advanced fibrosis or cirrhosis.
To read the aidsmap article, click here.
To read the study abstract, click here.