Liver fibrosis is associated with cognitive impairment in people living with HIV

Nicoletta Ciccarelli, Massimiliano Fabbiani, Anna C Brita, Ramona De Marco, Pierfrancesco Grima, Roberta Gagliardini, Alberto Borghetti, Roberto Cauda, Simona Di Giambenedetto

Research output: Contribution to journalArticle


PURPOSE: Our aim was to better explore the association between liver fibrosis (LF) and neurocognitive impairment (NCI) in people living with HIV (PLWH). METHODS: We performed a cross-sectional cohort study by consecutively enrolling PLWH at two clinical centers. All subjects underwent a comprehensive neuropsychological battery; NCI was defined as having a pathological performance (1.5 SD below the normative mean) on at least two cognitive domains. LF was explored using FIB4 index; in a subgroup of PLWH, LF was also assessed by transient elastography. RESULTS: A total of 386 subjects were enrolled, of whom 17 (4.4%) had FIB4 > 3.25. In the subgroup of PLWH (N = 127) performing also liver transient elastography, 14 (11%) had liver stiffness > 14 kPa. Overall, 47 subjects (12%) were diagnosed with NCI. At multivariate regression analyses, participants with FIB4 > 1.45 showed a higher risk of NCI in comparison with those with lower values (aOR 3.04, p = 0.044), after adjusting for education (aOR 0.71, p  14 kPa showed an independent association with a higher risk of NCI (aOR 10.13, p = 0.041). Analyzing any single cognitive domain, a higher risk of abnormal psychomotor speed was associated with a liver stiffness > 14 kPa (aOR 223.17, p = 0.019) after adjusting for education (aOR 0.57, p = 0.018), HIV-RNA 
Original languageEnglish
Pages (from-to)589-593
Number of pages5
Issue number4
Publication statusPublished - Aug 2019



  • Co-infection
  • Cognitive impairment
  • Fib4
  • Liver fibrosis
  • Adult
  • Cognitive Dysfunction/complications/*epidemiology
  • Cohort Studies
  • Coinfection/*complications
  • Cross-Sectional Studies
  • Female
  • HIV Infections/*complications
  • Hepatitis C/*complications
  • Humans
  • Liver Cirrhosis/*complications
  • Male
  • Middle Aged

Cite this

Ciccarelli, N., Fabbiani, M., Brita, A. C., De Marco, R., Grima, P., Gagliardini, R., Borghetti, A., Cauda, R., & Di Giambenedetto, S. (2019). Liver fibrosis is associated with cognitive impairment in people living with HIV. Infection, 47(4), 589-593.