In:
AIDS, Ovid Technologies (Wolters Kluwer Health)
Abstract:
Hepatic steatosis, including non-alcoholic fatty liver disease (NAFLD), is common among people with HIV (PWH). We present baseline steatosis prevalence and cardiometabolic characteristics among REPRIEVE substudy participants. Methods: REPRIEVE is an international, primary cardiovascular disease prevention, randomized, controlled trial of pitavastatin calcium vs. placebo among 7,769 PWH ages 40–75 years on antiretroviral therapy (ART) and with low-to-moderate cardiovascular risk. A subset of participants underwent non-contrast computed tomography, with hepatic steatosis defined as mean hepatic attenuation 〈 40 HU or liver/spleen ratio 〈 1.0, and NAFLD defined as steatosis in the absence of frequent alcohol use or viral hepatitis. Results: Of 687 evaluable persons, median age was 51 years, BMI 27 kg/m 2 , CD4 + T cell count 607 cells/mm 3 ; 17% natal female sex, 36% Black, 24% Hispanic, and 98% HIV-1 RNA 〈 400 copies/mL. Hepatic steatosis prevalence was 22% (149/687), and NAFLD 21% (96/466). Steatosis/NAFLD prevalence was higher in males and with older age, non-Black race, and higher BMI and waist circumference. Both were associated with BMI 〉 30 kg/m 2 , Metabolic Syndrome components, higher ASCVD risk score, HOMA-IR, LpPLA-2 and hs-CRP, and lower high-density lipoprotein cholesterol. Of HIV-/ART-specific characteristics, only history of an AIDS-defining illness was more common among persons with steatosis/NAFLD. After adjusting for age, sex and race/ethnicity, BMI 〉 30 kg/m 2 , HOMA-IR 〉 2.0, Metabolic Syndrome and each of its components were associated with NAFLD prevalence. Conclusions: In this cohort with controlled HIV and low-to-moderate cardiovascular risk, hepatic steatosis and NAFLD were common and associated with clinically relevant metabolic and inflammatory disturbances, but not current HIV- or ART-related factors.
Type of Medium:
Online Resource
ISSN:
0269-9370
,
1473-5571
DOI:
10.1097/QAD.0000000000003671
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2023
detail.hit.zdb_id:
2012212-3
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