title: Predictors of chronic liver disease in individuals with human immunodeficiency virus infection.
abstract: INTRODUCTION. Chronic liver disease (CLD) is becoming a major cause of mortality in patients who are positive with human immunodeficiency virus (HIV). Our aim was to assess the prevalence of CLD in HIV+ individuals. MATERIAL AND METHODS. We utilized the National Health and Nutrition Examination Survey (1999-2008) to assess the association of CLD with HIV infection. In eligible participants (18-49 years), HIV infection was defined as positive anti-HIV by enzyme immunoassay further confirmed by Western blot. The diagnosis of CLD included chronic hepatitis C (CH-C), alcohol-related liver disease (ALD) and non-alcoholic fatty liver disease (NAFLD). Clinic-demographic and laboratory parameters were used to assess differences between those with and without HIV infection. RESULTS. 14,685 adults were included. Of those, 0.43 ± 0.08% were HIV-positive and 13.8% had evidence of CLD, including 26.3% in HIV-positive individuals and 13.7% in HIV-negative controls (p = 0.0341). In the U.S. population, independent predictors of CLD included HIV positivity [OR = 1.96 (1.02-3.77), p = 0.04], older age [OR = 1.03 (1.02-1.03), p < 0.0001], male gender [OR = 2.15 (1.89-2.44), p < 0.0001] and obesity [OR = 2.10 (1.82-2.43), p < 0.0001], while African American race/ethnicity was associated with lower risk for CLD [OR = 0.68 (0.58-0.80), p < 0.0001]. CONCLUSIONS. CLD is common in HIV positive individuals. With successful long term treatment of HIV, management of CLD will continue to remain very important in these patients.
authors.affiliation: Center for Liver Diseases and Department of Medicine, Inova Fairfax Hospital, Falls Church, VA, USA.
authors.forename: Nila
authors.initials: N
authors.lastname: Rafiq
authors.affiliation: Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, USA.
authors.forename: Maria
authors.initials: M
authors.lastname: Stepanova
authors.affiliation: Center for Liver Diseases and Department of Medicine, Inova Fairfax Hospital, Falls Church, VA, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Lam
authors.affiliation: Center for Liver Diseases and Department of Medicine, Inova Fairfax Hospital, Falls Church, VA, USA; Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, USA.
authors.forename: Fatema
authors.initials: F
authors.lastname: Nader
authors.affiliation: Center for Liver Diseases and Department of Medicine, Inova Fairfax Hospital, Falls Church, VA, USA; Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, USA.
authors.forename: Manirath
authors.initials: M
authors.lastname: Srishord
authors.affiliation: Center for Liver Diseases and Department of Medicine, Inova Fairfax Hospital, Falls Church, VA, USA; Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, USA.
authors.forename: Zobair M
authors.initials: ZM
authors.lastname: Younossi
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D060085:Coinfection; D005234:Fatty Liver / Q000453:epidemiology* / Q000208:ethnology; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000208:ethnology; D019698:Hepatitis C, Chronic / Q000453:epidemiology* / Q000208:ethnology; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008108:Liver Diseases, Alcoholic / Q000453:epidemiology* / Q000208:ethnology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease; D009749:Nutrition Surveys; D015995:Prevalence; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult