Among people with HIV, non-alcoholic fatty liver disease (NAFLD) is linked to a higher risk of health problems related to metabolism.

Researchers studied 485 people with HIV who did not have hepatitis B or C, monitoring them for a median of 40 months. At the outset of the study, 38% of the participants had NAFLD, including 17% who had the more advanced form of the disease, non-alcoholic steatohepatitis (NASH). Fifteen percent were suspected to have substantial fibrosis (scarring) of the liver, and 2.5% were believed to have cirrhosis, the most advanced stage of fibrosis.

After adjusting the data to account for various differences among the cohort members, the study authors found that having NAFLD, compared with not having the condition, was associated with a 5.1-fold increased risk of developing diabetes during follow-up and a 2.4-fold increased risk of developing irregular blood lipid levels.

“People with HIV and fatty liver should be closely monitored by their physician for development of these important metabolic conditions,” says the study’s lead author, Giada Sebastiani, MD, an associate professor of medicine at McGill University Health Centre in Montreal. “Also, modifiable risks should be addressed, especially [being] overweight or [having] obesity. Lifestyle modification, regular physical activity and diet are the cornerstones of the therapy for fatty liver. Finally, our findings provide a further argument to advocate for screening for fatty liver in people with HIV.”