title: Hepatic fibrosis and factors associated with liver stiffness in HIV mono-infected individuals.
abstract: BACKGROUND
  Liver disease has become an important cause of morbidity and mortality even in those HIV-infected individuals who are devoid of hepatitis virus co-infection. The aim of this study was to evaluate the degree of hepatic fibrosis and the role of associated factors using liver stiffness measurement in HIV mono-infected patients without significant alcohol intake.
  
  
  METHODS
  We performed a cross-sectional study of 101 HIV mono-infected patients recruited prospectively from March 1, 2014 to October 30, 2014 at the Center for HIV, St István and St László Hospital, Budapest, Hungary. To determine hepatic fibrosis, liver stiffness was measured with transient elastography. Demographic, immunologic and other clinical parameters were collected to establish a multivariate model. Bayesian Model Averaging (BMA) was performed to identify predictors of liver stiffness.
  
  
  RESULTS
  Liver stiffness ranged from 3.0-34.3 kPa, with a median value of 5.1 kPa (IQR 1.7). BMA provided a very high support for age (Posterior Effect Probability-PEP: 84.5%), moderate for BMI (PEP: 49.3%), CD4/8 ratio (PEP: 44.2%) and lipodystrophy (PEP: 44.0%). For all remaining variables, the model rather provides evidence against their effect. These results overall suggest that age and BMI have a positive association with LS, while CD4/8 ratio and lipodystrophy are negatively associated.
  
  
  CONCLUSIONS
  Our findings shed light on the possible importance of ageing, overweight and HIV-induced immune dysregulation in the development of liver fibrosis in the HIV-infected population. Nonetheless, further controlled studies are warranted to clarify causal relations.
authors.affiliation: Doctoral School for Clinical Medicine, Semmelweis University, Budapest, Hungary; Institute for Tropical Medicine, Eberhard Karls University, Tuebingen, Germany.
authors.forename: Mihály
authors.initials: M
authors.lastname: Sulyok
authors.affiliation: John von Neumann Faculty of Informatics, Physiological Controls Group, Óbuda University , Budapest , Hungary.
authors.forename: Tamás
authors.initials: T
authors.lastname: Ferenci
authors.affiliation: Center for Hepatology, St. István and St László Hospital, Budapest, Hungary; Hepatology Center of Buda, Budapest, Hungary.
authors.forename: Mihály
authors.initials: M
authors.lastname: Makara
authors.affiliation: Hepatology Center of Buda , Budapest , Hungary.
authors.forename: Gábor
authors.initials: G
authors.lastname: Horváth
authors.affiliation: Center for HIV, St. István and St László Hospital , Budapest , Hungary.
authors.forename: János
authors.initials: J
authors.lastname: Szlávik
authors.affiliation: Center for HIV, St. István and St László Hospital , Budapest , Hungary.
authors.forename: Zsófia
authors.initials: Z
authors.lastname: Rupnik
authors.affiliation: Center for HIV, St. István and St László Hospital , Budapest , Hungary.
authors.forename: Luca
authors.initials: L
authors.lastname: Kormos
authors.affiliation: Transplantation and Surgical Clinic, Semmelweis University , Budapest , Hungary.
authors.forename: Zsuzsanna
authors.initials: Z
authors.lastname: Gerlei
authors.affiliation: Institute for Tropical Medicine, Eberhard Karls University , Tuebingen , Germany.
authors.forename: Zita
authors.initials: Z
authors.lastname: Sulyok
authors.affiliation: Center for Hepatology, St. István and St László Hospital, Budapest, Hungary; Center for HIV, St. István and St László Hospital, Budapest, Hungary.
authors.forename: István
authors.initials: I
authors.lastname: Vályi-Nagy
keywords: Ageing; Antiretroviral therapy; Bayesian model averaging; Elasticity imaging techniques; HIV; Lipodystrophy; Liver fibrosis