title: Changes in liver steatosis evaluated by transient elastography with the controlled attenuation parameter in HIV-infected patients.
abstract: There are scant data on the progression of hepatic steatosis (HS) in HIV infection. We therefore evaluated changes in HS over time in HIV-infected patients using the controlled attenuation parameter (CAP).
  
  
  
  A prospective cohort of 326 HIV-infected patients was included in this study. All patients underwent a CAP measurement. Changes in steatosis were evaluated by calculating the median (Q1-Q3) difference between baseline and 12-month CAP values.
  
  
  
  The median (Q1-Q3) CAP was 221 (196-252) dB/m at baseline and 224 (198-257) dB/m at the 12-month visit (P = 0.617). Significant steatosis, that is, CAP ≥ 238 dB/m, was observed in 76 individuals (37%) at baseline and in 80 (39%) at the 12-month visit (P = 0.683). The following variables were associated with ΔCAP: plasma HIV RNA [< 50 vs. ≥ 50 HIV-1 RNA copies/mL: median (Q1-Q3) ΔCAP, 4 (-21, 27) vs. -21 (-49, 4) dB/m, respectively; P = 0.024]; body mass index (BMI) [no increase vs. increase: -13 (-40, 4) vs. 14 (-6, 32) dB/m, respectively; P < 0.001]; triglycerides [no increase vs. increase: -1 (-30, 22) vs. 15 (-3, 40) dB/m, respectively; P = 0.001]; fasting plasma glucose [not impaired vs. impaired: -4 (-31, 16) vs. 30 (15, 49) dB/m, respectively; P < 0.001]; and raltegravir [no vs. yes: 5 (-20, 29) vs. -11 (-37.5, 15) dB/m, respectively; P = 0.018]. The only factor independently associated with ΔCAP was BMI [B (standard error): 9.03 (1.9); P < 0.001].
  
  
  
  Increases in CAP values over a period of 12 months in HIV-infected patients were strongly associated with elevations in BMI. Other metabolic factors and antiretroviral drugs were not predictors of CAP changes independent of BMI.
authors.affiliation: Infectious Diseases and Microbiology Unit, Valme University Hospital, Seville, Spain. juan.macias.sanchez@gmail.com.|Institute of Biomedicine from Seville (IBiS), Seville, Spain. juan.macias.sanchez@gmail.com.
authors.forename: J
authors.initials: J
authors.lastname: Macías
authors.affiliation: Infectious Diseases and Microbiology Unit, Valme University Hospital, Seville, Spain.|Institute of Biomedicine from Seville (IBiS), Seville, Spain.
authors.forename: L M
authors.initials: LM
authors.lastname: Real
authors.affiliation: Infectious Diseases Unit, Institute Maimónides of Biomedical Research from Cordoba, Cordoba, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Rivero-Juárez
authors.affiliation: Infectious Diseases and Microbiology Unit, Valme University Hospital, Seville, Spain.|Institute of Biomedicine from Seville (IBiS), Seville, Spain.
authors.forename: N
authors.initials: N
authors.lastname: Merchante
authors.affiliation: Infectious Diseases Unit, Institute Maimónides of Biomedical Research from Cordoba, Cordoba, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Camacho
authors.affiliation: Infectious Diseases and Microbiology Unit, Valme University Hospital, Seville, Spain.|Institute of Biomedicine from Seville (IBiS), Seville, Spain.
authors.forename: K
authors.initials: K
authors.lastname: Neukam
authors.affiliation: Infectious Diseases Unit, Institute Maimónides of Biomedical Research from Cordoba, Cordoba, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Rivero
authors.affiliation: Infectious Diseases and Microbiology Unit, Valme University Hospital, Seville, Spain.|Institute of Biomedicine from Seville (IBiS), Seville, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Mancebo
authors.affiliation: Infectious Diseases and Microbiology Unit, Valme University Hospital, Seville, Spain.
authors.forename: J A
authors.initials: JA
authors.lastname: Pineda
mesh_terms: D000328:Adult; D015992:Body Mass Index; D054459:Elasticity Imaging Techniques; D005234:Fatty Liver / Q000175:diagnosis* / Q000473:pathology*; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
keywords: 
  HIV
  ; body mass index; controlled attenuation parameter; liver steatosis