title: Prospective evaluation of hepatic steatosis in HIV-infected patients with or without hepatitis C virus co-infection.
abstract: BACKGROUND
  Limited data are available on hepatic steatosis (HS) in HIV patients who are not infected with hepatitis C virus (HCV). The aims of this study were to assess the prevalence of HS and its risk factors in HIV patients with and without HCV infection, and to evaluate whether HS correlates with advanced liver fibrosis and/or cardiovascular disease risk.
  
  
  METHODS
  Fifty-seven HIV mono-infected and 61 HIV/HCV co-infected patients were enrolled consecutively. All patients underwent liver ultrasound and transient elastography. The main parameters of liver function, HIV and HCV viral loads, CD4+ cell counts, and data on highly active antiretroviral therapy (HAART) were recorded. Cardiovascular disease risk was evaluated using the 10-year Framingham risk score.
  
  
  RESULTS
  HS prevalence in the whole HIV population was 53% (54% in mono-infected patients and 51% in co-infected patients). HS was associated with lipodystrophy and triglyceride values (p<0.0001), metabolic syndrome (p<0.0004), and total cholesterol levels (p<0.001) in both HIV groups. In HIV mono-infected patients, HS was linked with HAART exposure of >1 year (p<0.01). By multivariate analysis, only triglyceride levels (p<0.02) and Framingham risk score (p<0.05) were independently associated with HS in both HIV groups. No correlation was observed between HS and advanced liver fibrosis, measured by transient elastography.
  
  
  CONCLUSIONS
  HS was common in HIV patients, occurring in about half of the population. HS was found to be linked with the Framingham risk score, but was not correlated with advanced liver fibrosis. We suggest that in our HIV population with HS, the burden of cardiovascular disease risk is greater than that of liver disease progression.
authors.affiliation: Department of Health Promotion Sciences, Infectious Diseases Section, University of Palermo, Palermo, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Li Vecchi
authors.forename: Maurizio
authors.initials: M
authors.lastname: Soresi
authors.forename: Lydia
authors.initials: L
authors.lastname: Giannitrapani
authors.forename: Paola
authors.initials: P
authors.lastname: Di Carlo
authors.forename: Giovanni
authors.initials: G
authors.lastname: Mazzola
authors.forename: Pietro
authors.initials: P
authors.lastname: Colletti
authors.forename: Antonino
authors.initials: A
authors.lastname: Terranova
authors.forename: Giovanni
authors.initials: G
authors.lastname: Vizzini
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Montalto
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D002318:Cardiovascular Diseases / Q000150:complications; D060085:Coinfection / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D005234:Fatty Liver / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000821:virology*; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D006526:Hepatitis C / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D014463:Ultrasonography
chemical_list: D019380:Anti-HIV Agents