Traditional but not HIV-related factors are associated with nonalcoholic fatty liver disease in Asian patients with HIV-1 infection.
BACKGROUND
The prevalence and factors associated with nonalcoholic fatty liver disease (NAFLD) are largely unknown in HIV-1 monoinfected patients.


METHODS
The present study elucidated the prevalence and factors associated with NAFLD among Asian patients with HIV-1 infection who underwent abdominal ultrasonography between January 2004 and March 2013. Diagnosis of NAFLD was based on the liver to kidney contrast and diffusion in hepatic echogenicity. Uni- and multi-variate logistic regression analyses were applied to estimate factors associated with NAFLD.


RESULTS
435 Asian patients free of chronic hepatitis B or C virus infection and without excessive alcohol intake were analyzed. NAFLD was diagnosed in 135 (31%) patients. Obesity (BMI >30 kg/m(2)) was evident in 18 (4.1%) patients, and BMI was >25 kg/m(2) in 103 (24%). Multivariate analysis identified higher BMI (per 1 kg/m(2) increment, adjusted OR = 1.198; 95% CI, 1.112-1.290; p<0.001), dyslipidemia (adjusted OR = 2.045; 95% CI, 1.183-3.538; p = 0.010), and higher ALT to AST ratio (per 1 increment, adjusted OR = 3.557; 95% CI, 2.129-5.941; p<0.001) as significant factors associated with NAFLD. No HIV-specific variables, including treatment with dideoxynucleoside analogues (didanosine, stavudine, and zalcitabine) and cumulative duration of antiretroviral therapy (ART), were associated with NAFLD.


CONCLUSIONS
The incidence of NALFD among Asian patients with HIV-1 infection is similar to that in Western countries. NAFLD was associated with high BMI, dyslipidemia, and high ALT/AST ratio, but not with HIV-related factors. The results highlight the importance of early recognition and management of NAFLD and traditional factors associated with NAFLD for Asian patients with HIV-1 infection.
AIDS Clinical Center, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan ; Center for AIDS Research, Kumamoto University, Kumamoto, Japan.
Takeshi
T
Nishijima
AIDS Clinical Center, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan ; Center for AIDS Research, Kumamoto University, Kumamoto, Japan.
Hiroyuki
H
Gatanaga
Department of Clinical Study and Informatics, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan.
Takuro
T
Shimbo
Department of Community Care, Saku Central Hospital, Nagano, Japan.
Hirokazu
H
Komatsu
Gastroenterology/Hepatology, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan.
Yuichi
Y
Nozaki
Gastroenterology/Hepatology, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan.
Naoyoshi
N
Nagata
AIDS Clinical Center, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan.
Yoshimi
Y
Kikuchi
Gastroenterology/Hepatology, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan.
Mikio
M
Yanase
AIDS Clinical Center, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan ; Center for AIDS Research, Kumamoto University, Kumamoto, Japan.
Shinichi
S
Oka
D000328:Adult; D044466:Asian People; D003430:Cross-Sectional Studies; D005234:Fatty Liver / Q000150:complications / Q000453:epidemiology*; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease