Thirty-three percent of young adults with HIV since birth or early childhood have hepatic steatosis, a prevalence comparable to older adults with HIV and “significantly higher” than HIV-negative controls, according to research published in The Journal of Infectious Diseases
“In this cross-sectional study of young adults with life-long HIV, we identified that one-third of the cohort had evidence of fatty liver using noninvasive transient elastography techniques,” Colleen Hadigan, MD, MPH, a staff clinician in the laboratory of immunoregulation at the National Institute of Allergy and Infectious Diseases, told Infectious Disease News.
According to Hadigan and colleagues, patients who are infected with HIV early in life “represent the first generation of young adults growing up with life-long exposure to HIV and ART. Living with HIV since birth or early childhood may exacerbate the relationship between HIV and hepatic steatosis through prolonged exposure to ART, metabolic syndrome and chronic inflammation; however, little is known about the prevalence and risk factors for hepatic steatosis in this unique population.”
The researchers used transient elastography to evaluate liver fibrosis and steatosisin 46 young adults with life-long HIV — acquired perinatally or through transfusion — and 20 HIV-negative control participants who were matched by age, race and sex. Seventy percent of the participants in the HIV cohort (61% female; mean age, 28 years) were virally suppressed, with viral loads less than 40 copies/mL. They had a mean CDR T-cell count of 605 cells/µL and an average of 19 years of ART exposure.
Hadigan and colleagues reported that steatosis was present in 33% of the life-long HIV cohort and 10% of the controls (P = .04). Scores for haptic fibrosis were not elevated and did not differ between the cohorts, the researchers wrote.
“Central adiposity, as measured by waist circumference, was the single strongest factor associated with hepatic steatosis in this cohort, whereas HIV-associated factors such as antiretroviral exposure and CD4 count were not,” Hadigan said. “While this finding should be replicated in larger cohorts, modifiable metabolic disturbances may be important targets to optimize liver health in this unique population.”
Hadigan and colleagues also noted that the results for hepatic steatosis in the study were consistent with other studies of older, largely male populations of adults with HIV infection.
By Bruce Thiel