Xu Wei, Liu Danping, Zhang Renfang, Chen Jun, Shen Yinzhong
Department of Infection and Immunity, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.
Open Forum Infect Dis. 2025 Jul 2;12(7):ofaf369. doi: 10.1093/ofid/ofaf369. eCollection 2025 Jul.
We aimed to investigate the prevalence of liver fibrosis and identify the associated risk factors among people with HIV (PWH) and metabolic dysfunction-associated steatotic liver disease (MASLD).
Abdominal ultrasonography and transient elastography were performed to assess liver fibrosis and steatosis. Lean MASLD was defined as MASLD occurring in PWH with a body mass index (BMI) < 24 kg/m. A cutoff of liver stiffness measurement ≥ 7.1 kPa was set for significant liver fibrosis. The prevalence, correlation factors, and risk factors were evaluated.
Among 361 PWH, 250 (69.25%) had a BMI < 24 kg/m, and 141 (39.06%) were diagnosed with MASLD. The 141 PWH with MASLD were classified as 2 groups based on BMI: 58 (41.13%) as lean MASLD and 83 (58.87%) as overweight MASLD. Significant fibrosis was observed in 121 of the 361 PWH, including 75 of the 141 with MASLD, 28 of the 58 with lean MASLD, and 47 of the 83 with overweight MASLD. Among PWH with MASLD, independent risk factors for significant liver fibrosis included higher alanine aminotransferase levels and the presence of type 2 diabetes. Among PWH with lean MASLD, independent risk factors for significant liver fibrosis included elevated aspartate aminotransferase levels and the administration of non-nucleoside reverse transcriptase inhibitors.
Significant liver fibrosis is highly prevalent among PWH and MASLD. Multiple risk factors are associated with significant liver fibrosis among PWH. These findings underscore the importance of early identification and management of liver fibrosis in PWH.
NCT04215926.
我们旨在调查艾滋病毒感染者（PWH）和代谢功能障碍相关脂肪性肝病（MASLD）患者中肝纤维化的患病率，并确定相关危险因素。
进行腹部超声检查和瞬时弹性成像以评估肝纤维化和脂肪变性。瘦型MASLD定义为体重指数（BMI）<24 kg/m的PWH中发生的MASLD。将肝脏硬度测量值≥7.1 kPa设定为显著肝纤维化的临界值。评估患病率、相关因素和危险因素。
在361例PWH中，250例（69.25%）BMI<24 kg/m，141例（39.06%）被诊断为MASLD。141例患有MASLD的PWH根据BMI分为两组：58例（41.13%）为瘦型MASLD，83例（58.87%）为超重型MASLD。361例PWH中有121例观察到显著纤维化，包括141例患有MASLD的患者中的75例、58例瘦型MASLD患者中的28例和83例超重型MASLD患者中的47例。在患有MASLD的PWH中，显著肝纤维化的独立危险因素包括较高的丙氨酸氨基转移酶水平和2型糖尿病的存在。在患有瘦型MASLD的PWH中，显著肝纤维化的独立危险因素包括天冬氨酸氨基转移酶水平升高和使用非核苷类逆转录酶抑制剂。
PWH和MASLD患者中显著肝纤维化非常普遍。多种危险因素与PWH中的显著肝纤维化相关。这些发现强调了早期识别和管理PWH肝纤维化的重要性。
NCT04215926。
