Lauren E Mellor-Crummey1, Jordan E Lake1,2, Holly Wilhalme2, Chi-Hong Tseng2, Philip M Grant3, Kristine M Erlandson4, Jennifer C Price5, Frank J Palella6, Larry A Kingsley7, Matthew Budoff8, Wendy S Post9, Todd T Brown9. 1. McGovern Medical School at the UT Health Science Center at Houston, Houston, TX, USA. 2. University of California Los Angeles, Los Angeles, CA, USA. 3. Stanford University, Stanford, CA, USA. 4. University of Colorado Anschutz Medical Campus, Aurora, CO, USA. 5. University of California San Francisco, San Francisco, CA, USA. 6. Northwestern University Feinberg School of Medicine, Chicago, IL, USA. 7. University of Pittsburgh, Pittsburgh, PA, USA. 8. Los Angeles Biomedical Research Institute, Torrance, CA, USA. 9. Johns Hopkins University, Baltimore, MD, USA.
Abstract
BACKGROUND AND AIM: Non-alcoholic fatty liver disease (NAFLD) is common among HIV-infected (HIV+) adults. The Liver Fat Score (LFS) is a non-invasive, rapid, inexpensive diagnostic tool that uses routine clinical data and is validated against biopsy in HIV-uninfected (HIV-) persons. CT liver-to-spleen (L/S) attenuation ratio is another validated method to diagnose NAFLD. We compared NAFLD prevalence using the LFS versus L/S ratio among Multicenter AIDS Cohort Study participants to assess the LFS's performance in HIV+vs. HIV-men. METHODS: In a cross-sectional analysis of men reporting<3 alcoholic drinks daily (308 HIV+, 218 HIV-), Spearman correlations determined relationships between LFS and L/S ratio by HIV serostatus. Multivariable regression determined factors associated with discordance in LFS- and L/S ratio-defined NAFLD prevalence. RESULTS: NAFLD prevalence by LFS and L/S ratio were 28%/15% for HIV+men and 20%/19% for HIV-men, respectively. Correlations between LFS and L/S ratio were weaker among HIV+than HIV-men, but improved with increasing BMI and exclusion of HCV-infected men. LFS and L/S ratio discordance occurred more frequently and across BMI strata among HIV+men, but predominantly at BMI<30 kg/m2 among HIV-men. In multivariate analysis, only lower total testosterone levels were significantly associated with discordance. CONCLUSION: NAFLD prevalence was similar by LFS and L/S ratio identification among HIV-men, but dissimilar and with frequent discordance between the two tests among HIV+men. As discordance may be multifactorial, biopsy data are needed to determine the best non-invasive diagnostic test for NAFLD in HIV+persons.
BACKGROUND AND AIM: Non-alcoholic fatty liver disease (NAFLD) is common among HIV-infected (HIV+) adults. The Liver Fat Score (LFS) is a non-invasive, rapid, inexpensive diagnostic tool that uses routine clinical data and is validated against biopsy in HIV-uninfected (HIV-) persons. CT liver-to-spleen (L/S) attenuation ratio is another validated method to diagnose NAFLD. We compared NAFLD prevalence using the LFS versus L/S ratio among Multicenter AIDS Cohort Study participants to assess the LFS's performance in HIV+vs. HIV-men. METHODS: In a cross-sectional analysis of men reporting<3 alcoholic drinks daily (308 HIV+, 218 HIV-), Spearman correlations determined relationships between LFS and L/S ratio by HIV serostatus. Multivariable regression determined factors associated with discordance in LFS- and L/S ratio-defined NAFLD prevalence. RESULTS: NAFLD prevalence by LFS and L/S ratio were 28%/15% for HIV+men and 20%/19% for HIV-men, respectively. Correlations between LFS and L/S ratio were weaker among HIV+than HIV-men, but improved with increasing BMI and exclusion of HCV-infected men. LFS and L/S ratio discordance occurred more frequently and across BMI strata among HIV+men, but predominantly at BMI<30 kg/m2 among HIV-men. In multivariate analysis, only lower total testosterone levels were significantly associated with discordance. CONCLUSION: NAFLD prevalence was similar by LFS and L/S ratio identification among HIV-men, but dissimilar and with frequent discordance between the two tests among HIV+men. As discordance may be multifactorial, biopsy data are needed to determine the best non-invasive diagnostic test for NAFLD in HIV+persons.
Entities:
Keywords:
Hepatic steatosis; Human immunodeficiency; Non-alcoholic steatohepatitis
Authors: Anne K Monroe; Adrian S Dobs; Xiaoqiang Xu; Frank J Palella; Lawrence A Kingsley; Mallory D Witt; Todd T Brown Journal: J Acquir Immune Defic Syndr Date: 2011-10-01 Impact factor: 3.731
Authors: Ani Kardashian; Yifei Ma; Rebecca Scherzer; Jennifer C Price; Monika Sarkar; Natalie Korn; Kyle Tillinghast; Marion G Peters; Susan M Noworolski; Phyllis C Tien Journal: AIDS Date: 2017-01-28 Impact factor: 4.177
Authors: Jennifer C Price; Eric C Seaberg; Rachel Latanich; Matthew J Budoff; Lawrence A Kingsley; Frank J Palella; Mallory D Witt; Wendy S Post; Chloe L Thio Journal: Am J Gastroenterol Date: 2014-03-18 Impact factor: 10.864