Swiss study reports on connection between physical activity, sitting, and liver steatosis in people with HIV

In people living with HIV, not being physically active, including regularly sitting for long periods, has negative effects on overall health and is specifically associated with a greater risk of developing liver steatosis, reports a single-site study in Switzerland.

About This Study

“Decreased physical activity and prolonged sitting time are associated with liver steatosis in people with HIV“ was published online on Nov. 21, 2023, in Journal of Acquired Immune Deficiency Syndromes. The lead author is Carlotta Riebensahm, M.D., of the Department of Infectious Diseases at Inselspital, the Bern University Hospital of the University of Bern and of the Graduate School of Health Sciences at the University of Bern, in Switzerland.

Key Research Findings

This single-site study investigated the relationship between physical activity and liver steatosis in 466 people living with HIV in Switzerland. Liver steatosis is common in this population due to the effects of HIV medications and the ongoing inflammation caused by the virus. Study participants’ median age was 52 years, 27% of participants were women, 73% of participants were white, and 52% of participants had a body mass index ≥25 kg/m², indicating they were overweight.

Participants’ liver condition was measured with vibration controlled transient elastography and physical activity was self-reported. Recommended physical activity thresholds are 200 min/week of moderate or 75 min/week of vigorous activity. The 32% of participants who met these thresholds were less likely to be overweight (43% of physically active vs. 57% of sedentary participants), have dyslipidemia (31% vs 42% of participants in each group), arterial hypertension (26% vs 33% of active and sedentary participants, respectively), or diabetes mellitus (7% vs 14% of participants in each group).

Overall, 50% of participants had liver steatosis, 34% with severe steatosis. Participants who did not meet physical activity thresholds were more than twice as likely to have that condition than more active participants. The same was true for sitting time–longer time sitting every day increased the likelihood of liver steatosis. The findings held independent of weight and after adjustment for taking antiretroviral drugs associated with weight gain.

Discussion Highlights and Implications for Practice

Study limitations reported included mostly white participants, the sample size of participants with advanced steatosis was small, and there was a lack of data on the timing of liver steatosis relative to physical activity.

The authors concluded that these findings indicate that decreased physical activity and prolonged sitting time are associated with liver steatosis, independent of weight. Researchers emphasized that, based on these results, all people living with HIV–lean or overweight–should be encouraged to be physically active and sit less, not just for their overall health, but also to prevent liver steatosis.

By Barbara Jungwirth