Metabolic Liver Research Program, I. Department of Medicine, University Medical Centre Mainz, Mainz, Germany.
I. Department of Medicine, University Medical Centre Mainz, Mainz, Germany.
Sci Rep. 2023 Jun 6;13(1):9158. doi: 10.1038/s41598-023-32965-y.
The prevalence of metabolic risk factors and non-alcoholic fatty liver disease (NAFLD) is high among people living with HIV (PLWH). Data on the recently proposed definition of metabolic dysfunction-associated fatty liver disease (MAFLD) in PLWH receiving antiretroviral therapy (ART) remains unknown. A total of 282 PLWH were included in this cross-sectional cohort study. Vibration-controlled transient elastography (VCTE) was used to assess hepatic steatosis and fibrosis. MAFLD and its subgroups (overweight/obese, lean/normal weight, and type 2 diabetes) were defined according to a recently published international consensus statement. The majority of this cohort was male (n = 198, 70.2%), and the median age was 51.5 years. The median BMI was 25 kg/m, and obesity was prevalent in 16.2% (n = 44). A total of 207 (73.4%) PLWH were classified as non-MAFLD while 75 (26.6%) qualified as MAFLD. The median CAP in the MAFLD group was 320 dB/m. PLWH with MAFLD showed a higher median LSM (p < 0.008) and were older (p < 0.005) compared to the non-MAFLD group. Overall, the metabolic risk profile was comparable between MAFLD and NAFLD. The majority of PLWH and MAFLD were overweight or obese (n = 58, 77.3%). The highest median LSM values were observed in the subgroup with MAFLD and type 2 diabetes. HIV-related parameters did not differ between non-MAFLD and MAFLD. The prevalence of MAFLD in PLWH is high and comparable to NAFLD. PLWH may be characterized according to the novel MAFLD criteria and its subgroups to identify patients at risk for chronic liver disease.
代谢危险因素和非酒精性脂肪性肝病（NAFLD）在 HIV 感染者（PLWH）中较为常见。在接受抗逆转录病毒治疗（ART）的 PLWH 中，关于最近提出的代谢功能障碍相关脂肪性肝病（MAFLD）的定义的数据尚不清楚。本横断面队列研究共纳入 282 例 PLWH。使用振动控制瞬时弹性成像（VCTE）评估肝脂肪变性和纤维化。根据最近发表的国际共识声明，定义 MAFLD 及其亚组（超重/肥胖、瘦/正常体重和 2 型糖尿病）。该队列的大多数患者为男性（n=198，70.2%），中位年龄为 51.5 岁。中位 BMI 为 25kg/m2，肥胖患病率为 16.2%（n=44）。共有 207 例（73.4%）PLWH 被归类为非 MAFLD，而 75 例（26.6%）符合 MAFLD 标准。MAFLD 组的中位 CAP 为 320dB/m。与非 MAFLD 组相比，MAFLD 组的中位 LSM 更高（p<0.008）且年龄更大（p<0.005）。总体而言，MAFLD 与 NAFLD 的代谢风险特征相当。大多数 PLWH 和 MAFLD 为超重或肥胖（n=58，77.3%）。MAFLD 和 2 型糖尿病亚组的中位 LSM 值最高。非 MAFLD 和 MAFLD 组的 HIV 相关参数无差异。PLWH 中 MAFLD 的患病率较高，与 NAFLD 相当。可根据新的 MAFLD 标准及其亚组对 PLWH 进行分类，以确定有发生慢性肝病风险的患者。
