title: Non-invasive assessment of liver steatosis and fibrosis in HIV/HCV- and HCV- infected patients.
abstract: BACKGROUND
  Conflicting data have been reported on the prevalence of liver steatosis, its risk factors and its relationship with fibrosis in patients with human immunodeficiency virus (HIV)/hepatitis C virus (HCV) co-infection or with HCV mono-infection.
  
  
  OBJECTIVE
  The study aims were to assess steatosis prevalence and its risk factors in both HCV groups. We also evaluated whether steatosis was linked with advanced fibrosis. Sixty-eight HIV/HCV co-infected and 69 HCV mono-infected patients were consecutively enrolled. They underwent liver ultrasonography and transient elastography. Bright liver echo-pattern was used to diagnose steatosis; advanced fibrosis was defined as liver stiffness ≥ 9.5 kPa and FIB-4 values ≥ 3.25. The optimal stiffness cut-off according to FIB-4 ≥ 3.25 was evaluated by ROC analysis.
  
  
  RESULTS
  No significant difference was found in steatosis-prevalence between mono- and co-infected patients (46.3 vs. 51.4%). Steatosis was associated with triglycerides and impaired fasting glucose/diabetes in HCV mono-infected, with lipodystrophy, metabolic syndrome, total-cholesterol and triglycerides in co-infected patients. Stiffness ≥ 9.5 was significantly more frequent in co-infection (P < 0.003). Advanced fibrosis wasn't significantly associated with steatosis. The area under the ROC curve was 0.85 (95% CI 0.79-0.9). On multivariate analysis steatosis was associated with triglycerides in both HCV mono- and co-infected groups (P < 0.02; P < 0.03).
  
  
  CONCLUSIONS
  Although steatosis was common in both HCV mono- and co-infected patients, it was not linked with advanced fibrosis. Triglycerides were independent predictors of steatosis in either of the HCV-groups. Dietary interventions and lifestyle changes should be proposed to prevent metabolic risk factors.
authors.affiliation: Biomedical Department of Internal Medicine and Specialties, University of Palermo, Via del Vespro 141, 90127 Palermo, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Li Vecchi
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: Emanuele
authors.initials: E
authors.lastname: La Spada
authors.forename: Giovanni
authors.initials: G
authors.lastname: Vizzini
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Montalto
authors.forename: Maurizio
authors.initials: M
authors.lastname: Soresi
mesh_terms: D000328:Adult; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D060085:Coinfection; D054459:Elasticity Imaging Techniques; D005234:Fatty Liver / Q000097:blood / Q000000981:diagnostic imaging* / Q000208:ethnology / Q000821:virology; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000208:ethnology; D019698:Hepatitis C, Chronic / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000208:ethnology*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008103:Liver Cirrhosis / Q000097:blood / Q000000981:diagnostic imaging* / Q000208:ethnology / Q000821:virology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D015995:Prevalence; D012372:ROC Curve; D012307:Risk Factors; D044465:White People
chemical_list: D015415:Biomarkers