Abstract
BackgroundSince Highly Active Antiretroviral Therapy (HAART) medications were made available in 2002, multiple serious side effects have been observed. However, no study has yet systematically evaluated the prevalence of liver steatosis, a very serious but treatable side effect.ObjectivesThis study examined the prevalence of and independent risk factors for liver steatosis in Chinese HIV-infected, HAART-experienced patients who had been diagnosed with hypertriglyceridemia.MethodsIn this cross-sectional observational study, the prevalence of liver steatosis was determined by ultrasound imaging that detected diffusion in hepatic echogenicity. The risk factors associated with steatosis were evaluated with a proportional odds logistic regression model.ResultsAmong 163 HIV-infected patients with hypertriglyceridemia and past HAART experience, 75(46%) patients were determined to have liver steatosis. In multivariable logistic regression model, the risk factors associated with liver steatosis were: higher triglyceride level (OR = 1.086, P = 0.026), metabolic syndromes (OR = 2.092, P = 0.024) and exposure to nucleoside reverse transcriptase inhibitor (NRTIs) ((OR = 2.11, P = 0.001) and Stavudine (OR = 3.75, P = 0.01)). Exposure to Nevirapine (OR = 0 .41, P = 0.003) was a favorable factor for lipid metabolism in vivo and was a protective factors for liver steatosis.ConclusionsChinese HIV-infected patients with hypertriglyceridemia appear to be prone to liver steatosis, especially those on NRTIs. Routine screening should be considered on their lipid panels.
Highlights
Since Highly Active Antiretroviral Therapy (HAART) medications were made available in 2002, multiple serious side effects have been observed
Chinese Human immunodeficiency virus (HIV)-infected patients with hypertriglyceridemia appear to be prone to liver steatosis, especially those on nucleoside reverse transcriptase inhibitor (NRTIs)
Participant characteristics and baseline descriptive data in HIV-infected patients with hypertriglyceridemia In this study, 180 HIV-infected patients with hypertriglyceridemia and past HAART experience have been recruited in several AIDS Treatment Centers in China (Table 1)
Summary
Since Highly Active Antiretroviral Therapy (HAART) medications were made available in 2002, multiple serious side effects have been observed. No study has yet systematically evaluated the prevalence of liver steatosis, a very serious but treatable side effect. Prevalence of nonalcoholic fatty liver disease(NAFLD) fluctuates between 20-30% in the general population [1,2]; in the U.S, it is between 17-33% [3,4,5]. Fan Jiangao et al [6] reported that the prevalence of liver steatosis was 15% in Shanghai general population and gradually increasing. Studies have shown that risk factors for liver steatosis include obesity, dyslipidemia, diabetes, insulin resistance and other factors. Among the HIV-infected population, the widespread use of HAART has reduced mortality and increased. We examined the prevalence of and risk factors associated with liver steatosis among a cohort of Chinese HIV-infected patients with hypertriglyceridemia
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