Z Gastroenterol 2019; 57(05): e160
DOI: 10.1055/s-0039-1691929
POSTER
Hepatologie
Georg Thieme Verlag KG Stuttgart · New York

Prevalence of non-alcoholic fatty liver disease (NAFLD) among HIV+ individuals in Vienna

C Schmidbauer
1   Wilhelminenspital, Department of Internal Medicine IV, Vienna, Austria
2   Medical University of Vienna, Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Vienna, Austria
3   Vienna HIV & Liver Study Group, Vienna, Austria
,
D Chromy
4   Medical University of Vienna, Department of Dermatology, Vienna, Austria
2   Medical University of Vienna, Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Vienna, Austria
3   Vienna HIV & Liver Study Group, Vienna, Austria
,
V Schmidbauer
5   Medical University of Vienna, Department of Biomedical Imaging and Image-guided Therapy, Vienna, Austria
,
M Mandorfer
2   Medical University of Vienna, Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Vienna, Austria
3   Vienna HIV & Liver Study Group, Vienna, Austria
,
B Scheiner
2   Medical University of Vienna, Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Vienna, Austria
3   Vienna HIV & Liver Study Group, Vienna, Austria
,
P Schwabl
2   Medical University of Vienna, Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Vienna, Austria
3   Vienna HIV & Liver Study Group, Vienna, Austria
,
T Bucsics
2   Medical University of Vienna, Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Vienna, Austria
3   Vienna HIV & Liver Study Group, Vienna, Austria
,
R Paternostro
2   Medical University of Vienna, Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Vienna, Austria
3   Vienna HIV & Liver Study Group, Vienna, Austria
,
B Simbrunner
2   Medical University of Vienna, Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Vienna, Austria
3   Vienna HIV & Liver Study Group, Vienna, Austria
,
A Rieger
4   Medical University of Vienna, Department of Dermatology, Vienna, Austria
,
H Holzmann
6   Medical University of Vienna, Center for Virology, Division of Applied Medical Virology, Vienna, Austria
,
M Gschwantler
1   Wilhelminenspital, Department of Internal Medicine IV, Vienna, Austria
,
M Trauner
2   Medical University of Vienna, Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Vienna, Austria
,
T Reiberger
2   Medical University of Vienna, Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Vienna, Austria
3   Vienna HIV & Liver Study Group, Vienna, Austria
› Author Affiliations
Further Information

Publication History

Publication Date:
16 May 2019 (online)

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Background & Aims:

Non-alcoholic fatty liver disease (NAFLD) is common in HIV+ individuals and might progress to steatohepatitis (NASH) and eventually cirrhosis. Some ART-regimens are known to cause metabolic alterations and promote NAFLD. We aimed to analyze epidemiological trends in prevalence and severity of NAFLD in our Viennese HIV+ cohort.

Method:

N = 1874 HIV+ patients attending our clinic between 2014 – 2016 were included. Epidemiological, clinical and laboratory parameters as well as ART regimens were retrospectively assessed at HIV-diagnosis (baseline) and at last contact. Patients with viral hepatitis and/or other known etiology of liver diseases were excluded. Prevalence of liver fibrosis according to NAFLD fibrosis scores (NFS) at first and last visit were analyzed.

Results:

After excluding n = 405/1874 (21.6%) patients mainly due to viral hepatitis, NFS was available in n = 1283 (87.3%). At baseline, dyslipidemia and diabetes were diagnosed in 413 (32.2%) and 19 (1.5%) patients, respectively. 1074 (83.7%) patients showed NFS<-1.455 (absence of advanced fibrosis) and n = 17 (1.3%) showed NFS≥0.676 (indicating F3/F4 NAFLD-fibrosis) at baseline, while n = 192 (15.0%) had intermediate NFS. Among patients with NFS-F3/F4 fibrosis, 1 (5.9%) had diabetes, 4 (23.5%) had dyslipidemia, and 5 (29.4%) were on HIV protease inhibitors (PI).

After a median follow-up of 5.9 years, 45/1469 (3.1%) patients had acquired viral hepatitis-coinfection. At follow-up, 63 (4.8%) had diabetes, 421 (31.8%) had dyslipidemia, and 188 (14.2%) were on PI-ART. Data for NFS-calculation was available in 1325/1424 (93.0%) patients at follow-up: n = 22 (1.7%) had NFS-F3/F4 fibrosis, including 10 (45.5%) with diabetes, 4 (18.2%) with dyslipidemia, and 9 (40.9%) on PI-containing ART.

Conclusion:

Although dyslipidemia, diabetes and PI-containing ART were common in HIV+ patients without viral hepatitis-coinfection, only 1.3 – 1.7% had suspected NAFLD-F3/F4 fibrosis. The study is limited by its retrospective design and lack of systematic imaging/elastography assessments. The true rate of NASH/NAFLD-fibrosis among the Viennese HIV+ patients remains to be established.