Prevalence and factors associated with liver steatosis as measured by transient elastography with controlled attenuation parameter in HIV-infected patients

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Objective:To assess the prevalence and factors associated with significant hepatic steatosis (SHS, steatosis involving ≥10% hepatocytes) in HIV-infected patients.Design:A prospective, cross-sectional study.Methods:Five hundred and five HIV-infected patients were included in this study. All patients underwent a transient elastography examination with the controlled attenuation parameter (CAP). SHS was defined using the previously identified CAP cut-off of 238 dB/m. We analysed the associations between SHS and demographics, metabolic data, coinfections and drug therapy.Results:SHS was detected in 201 (40%) patients. Individuals with and without plasma HIV RNA of 50 copies/ml or less presented SHS in 168 (42%) and 33 (31%) cases, respectively (P = 0.030). Patients with SHS compared with those without SHS presented higher median (IQR) BMI [BMI, 25.6 (22.5–28) vs. 22.3 (20.3–24.2) kg/m2; P < 10–6], DBP [79 (72–85) vs. 74 (68–81) mmHg; P = 0.0001], fasting plasma glucose [95 (87–106) vs. 91 (84–97) mg/dl; P = 0.002] and triglycerides [128 (92–189) vs. 109 (80–167) mg/dl; P = 0.002], and lower HDL cholesterol [44 (37–54) vs. 48 (40–59), mg/dl; P = 0.004]. In multivariate analysis, the only factor associated with SHS was BMI [per unit increase, adjusted odds ratio (95% confidence interval) 1.34 (1.22–1–47); P < 10–6].Conclusion:SHS measured by CAP is highly prevalent among HIV-infected patients. High BMI is the main predictor of SHS in this setting.

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