Non-invasive assessment of liver steatosis and fibrosis in HIV/HCV- and HCV- infected patients

Valentina Li Vecchi, Lydia Giannitrapani, Paola Di Carlo, Giovanni Mazzola, Pietro Colletti, Emanuele La Spada, Giovanni Vizzini, Giuseppe Montalto, Maurizio Soresi

Research output: Contribution to journalArticle

Abstract

Background. Conflicting data have been reported on the prevalence of liver steatosis, its risk factors and its relationship with fibrosis in patients with human immunodeficiency virus (HIV)/hepatitis C virus (HCV) co-infection or with HCV mono-infection. Aim. The study aims were to assess steatosis prevalence and its risk factors in both HCV groups. We also evaluated whether steatosis was linked with advanced fibrosis. Sixty-eight HIV/HCV co-infected and 69 HCV mono-infected patients were consecutively enrolled. They underwent liver ultrasonography and transient elastography. Bright liver echo-pattern was used to diagnose steatosis; advanced fibrosis was defined as liver stiffness ≥ 9.5 kPa and FIB-4 values ≥ 3.25. The optimal stiffness cut-off according to FIB-4 ≥ 3.25 was evaluated by ROC analysis. Results. No significant difference was found in steatosis-prevalence between mono- and co-infected patients (46.3 vs. 51.4%). Steatosis was associated with triglycerides and impaired fasting glucose/diabetes in HCV mono-infected, with lipodystrophy, metabolic syndrome, total-cholesterol and triglycerides in co-infected patients. Stiffness ≥ 9.5 was significantly more frequent in co-infection (P <0.003). Advanced fibrosis wasn't significantly associated with steatosis. The area under the ROC curve was 0.85 (95% CI 0.79-0.9). On multivariate analysis steatosis was associated with triglycerides in both HCV mono- and co-infected groups (P <0.02; P <0.03). Conclusion. Although steatosis was common in both HCV mono- and co-infected patients, it was not linked with advanced fibrosis. Triglycerides were independent predictors of steatosis in either of the HCV-groups. Dietary interventions and lifestyle changes should be proposed to prevent metabolic risk factors.

Original languageEnglish
Pages (from-to)740-748
Number of pages9
JournalAnnals of Hepatology
Volume12
Issue number5
Publication statusPublished - Sep 2013

Keywords

  • FIB-4
  • Hepatic steatosis
  • HIV/HCV co-infection
  • Liver fibrosis
  • Transient elastography

ASJC Scopus subject areas

  • Hepatology

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  • Cite this

    Li Vecchi, V., Giannitrapani, L., Di Carlo, P., Mazzola, G., Colletti, P., La Spada, E., Vizzini, G., Montalto, G., & Soresi, M. (2013). Non-invasive assessment of liver steatosis and fibrosis in HIV/HCV- and HCV- infected patients. Annals of Hepatology, 12(5), 740-748.