Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Department of Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Int J STD AIDS. 2021 Mar;32(3):266-275. doi: 10.1177/0956462420960997. Epub 2020 Dec 18.
Metabolic disorders are increasing in people living with HIV (PLWH), and metabolic associated fatty liver disease (MAFLD) has become a common complication. A cross-sectional study was conducted in HIV-positive persons receiving anti-retroviral therapy (ART), in order to determine the prevalence and predicting factors of MAFLD in PLWH. All participants underwent bioelectrical impedance analysis, ultrasonography, and transient elastography with controlled attenuation parameter (CAP). MAFLD was defined as CAP ≥248 dB/m. Significant fibrosis was defined when liver stiffness measurement >7.0 kPa. Predicting factors of MAFLD were determined using logistic regression analysis. Of 150 participants, 48 (32.0%) had MAFLD. Significant fibrosis was diagnosed in 5 (10.4%) participants in the MAFLD group. Blood pressure, waist circumference, body mass index (BMI), percentage of fat, serum transaminases, HbA1c, LDL, and triglycerides levels were significantly higher in the MAFLD group ( < 0.05). High BMI [odds ratio (OR) 1.596; 95% confidence interval (CI), 1.336-1.907, < 0.001], triglycerides level >150 mg/dl [OR 3.722; 95% CI, 1.508-9.187, < 0.004], and advanced age [OR 1.076; 95% CI, 1.017-1.139, < 0.011] were associated with MAFLD in the multivariate analysis. MAFLD is common in PLWH receiving ART, while significant fibrosis is relatively infrequent. High BMI, age, and triglycerides level are the predicting factors of MAFLD in PLWH.
代谢紊乱在接受抗逆转录病毒疗法 (ART) 的 HIV 感染者(PLWH)中越来越常见,代谢相关脂肪性肝病(MAFLD)已成为常见的并发症。本横断面研究旨在确定接受 ART 的 HIV 阳性者中 MAFLD 的患病率和预测因素。所有参与者均接受生物电阻抗分析、超声检查和受控衰减参数 (CAP) 的瞬时弹性成像。MAFLD 的定义为 CAP≥248dB/m。当肝硬度测量值>7.0kPa 时,诊断为显著纤维化。使用逻辑回归分析确定 MAFLD 的预测因素。在 150 名参与者中,48 名(32.0%)患有 MAFLD。在 MAFLD 组中,有 5 名(10.4%)患者诊断为显著纤维化。MAFLD 组的血压、腰围、体重指数(BMI)、体脂百分比、血清转氨酶、HbA1c、LDL 和甘油三酯水平显著升高(<0.05)。高 BMI[比值比(OR)1.596;95%置信区间(CI),1.336-1.907,<0.001]、甘油三酯水平>150mg/dl[OR 3.722;95% CI,1.508-9.187,<0.004]和年龄较大[OR 1.076;95% CI,1.017-1.139,<0.011]与多元分析中的 MAFLD 相关。MAFLD 在接受 ART 的 PLWH 中很常见,而显著纤维化相对少见。高 BMI、年龄和甘油三酯水平是 PLWH 中 MAFLD 的预测因素。