Adipose tissue and metabolic factors associated with steatosis in HIV/HCV coinfection: histology versus magnetic resonance spectroscopy.
BACKGROUND
Hepatic steatosis is common in persons with HIV and hepatitis C virus (HCV); yet biopsy measurement of steatosis is prone to sampling error. We compared magnetic resonance spectroscopy (MRS) measurement of steatosis to histology in HIV/HCV-coinfected patients and explored the associated adipose tissue and metabolic factors.


METHODS
Cross-sectional analysis of 42 HIV/HCV-coinfected men and women. Logistic regression analysis identified factors (MRI-measured visceral adipose tissue and abdominal subcutaneous adipose tissue and Homeostasis Model Assessment-estimated insulin resistance) associated with histologic steatosis (≥ 5% of hepatocytes with fat) and MRS steatosis (≥ 5% of hepatic fat).


RESULTS
MRS steatosis was strongly associated with histologic steatosis, when measured continuously (odds ratio: 10.2 per doubling of MRS-measured hepatic fat; 95% confidence interval: 2.9 to 69.3) and dichotomously (Kappa coefficient = 0.52; P = 0.0007). Four of the 10 with MRS-measured steatosis did not have histologic steatosis; 3 of 9 with histologic steatosis did not have MRS-measured steatosis (67% sensitivity; 88% specificity). Associations of visceral adipose tissue and abdominal subcutaneous adipose tissue were associated with both histologic and MRS-measured steatosis. Insulin resistance was also associated with both.


CONCLUSIONS
When compared with histology, MRS was similarly associated with adipose tissue and metabolic factors. MRS is a useful noninvasive alternative to biopsy in HIV/HCV coinfection.
Department of Medicine, California Pacific Medical Center, San Francisco, CA, USA.
Alireza
A
Ghotb
Susan M
SM
Noworolski
Erin
E
Madden
Rebecca
R
Scherzer
Aliya
A
Qayyum
Jane
J
Pannell
Linda
L
Ferrell
Marion
M
Peters
Phyllis C
PC
Tien
D000273:Adipose Tissue / Q000378:metabolism / Q000473:pathology*; D000328:Adult; D001706:Biopsy; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005234:Fatty Liver / Q000209:etiology* / Q000378:metabolism / Q000473:pathology; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000378:metabolism / Q000473:pathology; D006526:Hepatitis C / Q000150:complications* / Q000378:metabolism / Q000473:pathology; D006801:Humans; D008099:Liver / Q000473:pathology; D016015:Logistic Models; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio