Fatty Liver Disease in a Prospective North American Cohort of Adults with HIV and Hepatitis B Coinfection.

ABSTRACT:

Background

Hepatitis B (HBV) and fatty liver disease (FLD) are common etiologies of liver disease in HIV. Correlates of FLD and its relationship with alanine aminotransferase (ALT) overtime were examined in HIV-HBV coinfection.

Methods

From 04/28/14-11/07/18, 114 HIV-HBV adults underwent a liver biopsy and were followed for a median of 3 years (ancillary study of Hepatitis B Research Network). Steatohepatitis was based on presence of steatosis, ballooning and perisinusoidal fibrosis. FLD was defined as ≥5% steatosis and/or steatohepatitis.

Results

Median age was 49 years, 93% were male, 51% black, 93% had HIV RNA<400 copies/mL and 83% HBV DNA<1000 IU/mL. Thirty percent had FLD (20% steatosis, 10% steatohepatitis). Those with FLD had higher median triglyceride (171 versus 100 mg/dL, P<.01) and sdLDL (44 versus 29 mg/dL, P<.01) and lower HDL-2C (9 versus 12 mg/dL, P=.001). After adjusting for age, sex and alcohol use, white and other vs. black race (odds ratio [OR]=8.49 and OR=16.54, respectively, P=.0004), ALT (OR=3.13 per doubling, P=.003), hypertension (OR=10.93, P=.002), hyperlipidemia (OR=4.36, P=.04) and diabetes family history (OR=5.38, P=.02) were independently associated with having FLD. Steatohepatitis or steatosis alone (versus none) were associated with higher ALT overtime (1.93 and 1.34 times higher, respectively; P<.001), with adjustment for age, sex, and HBV DNA.

Conclusions

About 30% with HIV-HBV coinfection had FLD including 10% with steatohepatitis. FLD was associated with non-black race, metabolic risks, an increased atherogenic lipid profile, and elevated ALT overtime. Thus, identification of FLD and management of adverse metabolic profiles is critically important in HIV-HBV coinfection.

SUBMITTER: Khalili M 

PROVIDER: S-EPMC8563226 | biostudies-literature |

REPOSITORIES: biostudies-literature