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 journalArticlepeer-review

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

Fingerprint

Dive into the research topics of 'Non-invasive assessment of liver steatosis and fibrosis in HIV/HCV- and HCV- infected patients'. Together they form a unique fingerprint.

Cite this