BACKGROUND: There are limited data regarding the clinical, biochemical and liver histological characteristics of patients with HIV-associated nonalcoholic fatty liver disease (NAFLD), and whether this entity differs in presentation and severity from primary NAFLD AIM: To examine the clinical and histological differences between HIV-associated NAFLD and primary NAFLD. METHODS: This is a cross-sectional, case-control study comparing patients with HIV-associated NAFLD vs. patients with primary NAFLD. HIV-infected patients were identified from a database of consecutive liver biopsies performed at the University of California at San Diego, over a 13-year period. HIV-infected patients with biopsy-proven NAFLD were selected as cases, after exclusion of other causes of liver disease and hepatic steatosis. Age-sex-matched controls with biopsy-proven primary NAFLD were randomly identified from the same pathology database. All biopsies underwent a standardised, detailed, histological research evaluation by a liver pathologist who was blinded to clinical and case-control status. RESULTS: Compared to age-sex-matched patients with primary NAFLD (n = 33), patients with HIV-associated NAFLD (n = 33) had significantly higher mean aspartate aminotransferase (P < 0.001), alanine aminotransferase (P < 0.001), alkaline phosphatase (P = 0.003) and serum triglycerides (P = 0.024). Similarly, compared to age-sex-matched primary NAFLD, patients with HIV-associated NAFLD had significantly higher rates of definite steatohepatitis (37% vs. 63%, P = 0.04), and more features of liver injury, including lobular inflammation (<0.001) and acidophil bodies (<0.001). CONCLUSION: Compared to age-sex-matched primary NAFLD, HIV-associated NAFLD has increased severity of liver disease and a higher prevalence of NASH.
BACKGROUND: There are limited data regarding the clinical, biochemical and liver histological characteristics of patients with HIV-associated nonalcoholic fatty liver disease (NAFLD), and whether this entity differs in presentation and severity from primary NAFLD AIM: To examine the clinical and histological differences between HIV-associated NAFLD and primary NAFLD. METHODS: This is a cross-sectional, case-control study comparing patients with HIV-associated NAFLD vs. patients with primary NAFLD. HIV-infectedpatients were identified from a database of consecutive liver biopsies performed at the University of California at San Diego, over a 13-year period. HIV-infectedpatients with biopsy-proven NAFLD were selected as cases, after exclusion of other causes of liver disease and hepatic steatosis. Age-sex-matched controls with biopsy-proven primary NAFLD were randomly identified from the same pathology database. All biopsies underwent a standardised, detailed, histological research evaluation by a liver pathologist who was blinded to clinical and case-control status. RESULTS: Compared to age-sex-matched patients with primary NAFLD (n = 33), patients with HIV-associated NAFLD (n = 33) had significantly higher mean aspartate aminotransferase (P < 0.001), alanine aminotransferase (P < 0.001), alkaline phosphatase (P = 0.003) and serum triglycerides (P = 0.024). Similarly, compared to age-sex-matched primary NAFLD, patients with HIV-associated NAFLD had significantly higher rates of definite steatohepatitis (37% vs. 63%, P = 0.04), and more features of liver injury, including lobular inflammation (<0.001) and acidophil bodies (<0.001). CONCLUSION: Compared to age-sex-matched primary NAFLD, HIV-associated NAFLD has increased severity of liver disease and a higher prevalence of NASH.
Authors: Takara L Stanley; Lindsay T Fourman; Meghan N Feldpausch; Julia Purdy; Isabel Zheng; Chelsea S Pan; Julia Aepfelbacher; Colleen Buckless; Andrew Tsao; Anela Kellogg; Karen Branch; Hang Lee; Chia-Ying Liu; Kathleen E Corey; Raymond T Chung; Martin Torriani; David E Kleiner; Colleen M Hadigan; Steven K Grinspoon Journal: Lancet HIV Date: 2019-10-11 Impact factor: 12.767
Authors: Eric G Meissner; Mary McLaughlin; Lindsay Matthews; Ahmed M Gharib; Bradford J Wood; Elliot Levy; Ralph Sinkus; Kimmo Virtaneva; Dan Sturdevant; Craig Martens; Stephen F Porcella; Zachary D Goodman; Bittoo Kanwar; Robert P Myers; Mani Subramanian; Colleen Hadigan; Henry Masur; David E Kleiner; Theo Heller; Shyam Kottilil; Joseph A Kovacs; Caryn G Morse Journal: Liver Int Date: 2016-07-06 Impact factor: 5.828
Authors: Vanessa El Kamari; Corrilynn O Hileman; Pierre M Gholam; Manjusha Kulkarni; Nicholas Funderburg; Grace A McComsey Journal: Clin Gastroenterol Hepatol Date: 2018-06-14 Impact factor: 11.382