Etiology and Severity of Liver Disease in HIV-Positive Patients With Suspected NAFLD: Lessons From a Cohort With Available Liver Biopsies

Journal of Acquired Immune Deficiency Syndromes : JAIDS
Laura Iogna PratEmmanuel A Tsochatzis

Abstract

Spectrum of liver injury among HIV-positive people is wide; in particular, prevalence of nonalcoholic fatty liver disease (NAFLD) seems to be higher compared with HIV-negative people. We retrospectively evaluated all liver biopsies performed at Royal Free Hospital from 2000 to 2017 in HIV monoinfected patients with abnormal transaminases, to assess the underlying cause of liver disease and to characterize the extent of fibrosis. We furthermore evaluated the diagnostic accuracy of FIB4 and FibroScan as noninvasive tools for fibrosis assessment. Ninety-seven patients were included. Most common histological findings were NAFLD (28%), nonspecific changes (26%), and normal histology (13%). Twenty percent of the patients had significant fibrosis and 11% had advanced fibrosis. FIB4, at a cutoff of 1.3, had a specificity of 82% and negative predictive value (NPV) of 95% for exclusion of advanced fibrosis. FibroScan was available in 28% patients and 33% had a liver stiffness ≥7.5 kPa. FibroScan showed a specificity of 77% and NPV of 94% for exclusion of significant fibrosis. Among patients with NAFLD (n = 27), 18% had advanced fibrosis, whereas the majority (56%) did not have any fibrosis. The NPV of FIB4 for advanced fibrosis in these ...Continue Reading

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Citations

Mar 14, 2019·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Laura Iogna Prat, Emmanuel A Tsochatzis
Jan 19, 2020·Journal of the International AIDS Society·Michael J PelusoUNKNOWN SEARCH010/RV254 Study Group
Jun 3, 2021·Cells·Athanasios-Dimitrios Bakasis, Theodoros Androutsakos

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