Fatty liver and hyperlipidemia in a cohort of HIV-positive Africans on highly active antiretroviral therapy.
OBJECTIVE
To determine the prevalence of fatty liver and to assess its association with hyperlipidemia and other metabolic risk factors in HIV/AIDS patients on long-term antiretroviral therapy.


METHODS
A prospective cross-sectional study of 113 adults attending an urban outpatient HIV clinic in Lagos, Nigeria. Demographic characteristics were obtained using interviewer administered questionnaires, and serum levels of fasting glucose, total cholesterol, high-density lipoprotein (HDL-C) and low-density lipoprotein cholesterol (LDL-C), and alanine transaminase were determined. Ultrasound scan imaging was used to identify hepatic steatosis.


RESULTS
One hundred thirteen subjects, mean age (SD), 38.7 (9.9) years on highly active antiretroviral therapy (HAART) therapy for 6 to 42 months were evaluated. Sixty-six (58.4%) were female and 47 (41.6) were male. Fifteen (13.3%) had hepatic steatosis. Total cholesterol > 200 mg/dL, LDL-C > 130 mg/dL, and fasting serum triglycerides > 150 mg/dL were seen in 28%, 24% and 35%, respectively. The presence of fatty liver was significantly associated with hepatomegaly (p = .03) and elevated LDL-C (p = .01).


CONCLUSIONS
The prevalence of hepatic steatosis is lower than reported in Caucasian populations, but strongly associated with hepatomegaly and hyperlipidemia in subjects on long-term HAART. Early recognition of fatty liver and regular screening for lipid are warranted in Africans receiving long-term HAART.
Lesi
Olufunmilayo A
OA
Department of Medicine, University of Lagos Teaching Hospital, PMB 12003, Idi-Araba, Lagos, Nigeria. fulesi2@yahoo.com
Soyebi
Kofoworola S
KS
Eboh
Cosmas N
CN
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D002784:Cholesterol / Q000097:blood; D015331:Cohort Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005234:Fatty Liver / Q000097:blood / Q000453:epidemiology*; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology*; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood / Q000453:epidemiology*; D008297:Male; D009549:Nigeria / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D014280:Triglycerides / Q000097:blood; D014504:Urban Health / Q000706:statistics & numerical data
D014280:Triglycerides; D002784:Cholesterol