Predictors of Liver Fibrosis in HIV Identified

Although nonalcoholic fatty liver disease (NAFLD) is known to be a major cause of liver disease in people with HIV infection, much is still unclear about which of these patients are more likely to develop more serious forms of NAFLD.

In a study presented at the annual Conference on Retroviruses and Opportunistic Infections, researchers sought to identify predictors of fibrosis presence and progression in this population.

They conducted a randomized trial of tesamorelin, a growth hormone-releasing hormone analogue, for the treatment of NAFLD in HIV. The trial involved 61 participants with HIV and NAFLD and without cirrhosis. NAFLD was defined as hepatic fat fraction (HFF) ≥ 5% by magnetic resonance spectroscopy in the absence of active hepatitis B or C or excess alcohol consumption. Participants underwent liver biopsy at baseline and 12 months.

Overall, 43% of the 58 participants with available baseline biopsies had hepatic fibrosis, which was associated with greater visceral fat content at baseline, but not subcutaneous fat or body mass index.

Although the groups had similar HFF, those participants with fibrosis had higher NAFLD Activity Score, alanine aminotransferase, and aspartate aminotransferase. Higher baseline visceral fat was the only clinical predictor of fibrosis progression.

“High rates of liver fibrosis presence and progression were observed in a cohort with HIV and NAFLD. Individuals with greater visceral fat content at baseline were more likely to have baseline fibrosis and progression of fibrosis, suggesting that these patients should be closely monitored and targeted for intervention,” the researchers concluded.

—Michael Potts

Reference:

Fourman LT, Stanley TL, Feldpausch M, et al. Clinical predictors of liver fibrosis presence & progression in HIV-associated NAFLD. Paper presented at: Conference on Retroviruses and Opportunistic Infections; March 2020. Boston, Massachusetts. http://www.croiconference.org/sessions/clinical-predictors-liver-fibrosis-presence-progression-hiv-associated-nafld.