https://pubmed.ncbi.nlm.nih.gov/35013082/ NAFLD

AIDS. 2022 Jan 10.
doi: 10.1097/QAD.0000000000003170. Online ahead of print.

Prevalence of non-alcoholic fatty liver disease using non-invasive techniques among children, adolescents, and youths living with HIV

Itzíar Carrasco 1, Antonio Olveira, Ángel Lancharro, Luis Escosa, María José Mellado, Carmen Busca, María Luisa Montes, Cristina Diez, Sonia Alcolea, María Luisa Navarro, Talía Sainz

Abstract

Objective: The prevalence of subclinical liver abnormalities is high among people living with HIV, but data regarding perinatally HIV-infected children and adolescents (PHIV) are scarce. Non-invasive image techniques offer an opportunity to address non-alcoholic fatty liver disease (NAFLD) in a population in which the scores validated for adults have not been tested.

Design: Prospective cross-sectional study including PHIV and uninfected controls.

Methods: Non-invasive imaging techniques for the diagnosis of NAFLD and/or fibrosis were performed, and four scores to predict NAFLD were evaluated.

Results: Seventy-six participants (59.2% women) with a median of 19 years old (IQR: 15.5-25.6) were included, 38 were PHIV and 38 were age and sex-matched controls. All HIV participants were on ART at the moment of inclusion, and 86.8% were virologically suppressed. A total of 11 PHIV and three controls were diagnosed with NAFLD (28.9% vs. 7.9%; p = 0.02) by non-invasive imaging techniques. The performance of scores based on clinical and analytical parameters was very poor. Although non-significant, overweight was more common among participants with NAFLD, who had a significantly higher BMI. Differences in HIV-related parameters between the groups were non-significant, except for the CD4/CD8+ T-cells ratio, decreased among PHIV diagnosed with NAFLD (p = 0.04).

Conclusions: The prevalence of NAFLD was high (28.9%) among PHIV, and only partially explained by overweight and metabolic syndrome defining factors. The scores based on clinical and analytical parameters did not accurately identify subjects at risk. Therefore, liver ultrasound assessment should be considered for the screening of NAFLD among PHIV in routine clinical practice.