HIV Unit. Department of Internal Medicine, La Paz University Hospital, 28046 Madrid, Spain.
Department of Dermatology, La Paz University Hospital, 28046 Madrid, Spain.
Cells. 2021 May 4;10(5):1099. doi: 10.3390/cells10051099.
: Psoriasis is the most frequent skin disease in HIV-infected patients. Nonalcohol fatty liver disease (NAFLD) is more prevalent in patients with psoriasis. We report the prevalence of psoriasis and NAFLD and investigate risk factors of liver damage in HIV-infected patients with psoriasis. : We performed a retrospective observational study. Steatosis was defined as indicative abdominal ultrasound findings, CAP (controlled attenuated parameter by transient elastography) > 238 dB/m, and/or triglyceride and glucose index (TyG) > 8.38. Significant (fibrosis ≥ 2) and advanced liver fibrosis (fibrosis ≤ F3) were studied by transient elastography (TE) and/or FIB-4 using standard cutoff points. FIB-4 (Fibrosis 4 score) results were adjusted for hepatitis C (HCV)-coinfected patients. : We identified 80 patients with psoriasis (prevalence, 1.5%; 95% CI, 1.1-1.8). Psoriasis was severe (PASI > 10 and/or psoriatic arthritis) in 27.5% of cases. The prevalence of steatosis was 72.5% (95% CI, 65-85). Severe psoriasis was an independent risk factor for steatosis (OR, 12; 95% CI, 1.2-120; = 0.03). Significant liver fibrosis ( < 0.05) was associated with HCV coinfection (OR 3.4; 95% CI, 1.1-10.6), total CD4 (OR 0.99; 95% CI, 0.99-1), and time of efavirenz exposure (OR 1.2; 95% CI, 1.0-1.3). : The prevalence of psoriasis in HIV-infected patients was similar to that of the general population. Steatosis is highly prevalent, and severe psoriasis is an independent risk factor for steatosis in HIV-infected patients.
: 银屑病是 HIV 感染者中最常见的皮肤疾病。非酒精性脂肪性肝病（NAFLD）在银屑病患者中更为普遍。我们报告了 HIV 感染者中银屑病和 NAFLD 的患病率，并调查了银屑病 HIV 感染者肝损伤的危险因素。 : 我们进行了一项回顾性观察性研究。脂肪肝定义为腹部超声有提示性表现、受控衰减参数（CAP）>238dB/m 和/或甘油三酯和葡萄糖指数（TyG）>8.38。通过瞬时弹性成像（TE）和/或使用标准截断值的 FIB-4 研究显著（纤维化≥2）和晚期肝纤维化（纤维化≤F3）。FIB-4（纤维化 4 评分）结果针对丙型肝炎病毒（HCV）合并感染患者进行了调整。 : 我们共确定了 80 例银屑病患者（患病率为 1.5%；95%可信区间为 1.1-1.8）。27.5%的病例中银屑病严重（PASI>10 和/或银屑病关节炎）。脂肪肝的患病率为 72.5%（95%可信区间为 65-85）。严重银屑病是脂肪肝的独立危险因素（OR，12；95%可信区间，1.2-120； =0.03）。显著的肝纤维化（ < 0.05）与 HCV 合并感染（OR 3.4；95%可信区间，1.1-10.6）、总 CD4（OR 0.99；95%可信区间，0.99-1）和依非韦伦暴露时间（OR 1.2；95%可信区间，1.0-1.3）有关。 : HIV 感染者中银屑病的患病率与一般人群相似。脂肪肝患病率很高，严重银屑病是 HIV 感染者中脂肪肝的独立危险因素。
