The effect of weight gain and metabolic dysfunction-associated steatotic liver disease on liver fibrosis progression and regression in people with HIV.
AIDS
; 38(9): 1323-1332, 2024 07 15.
Article
em En
| MEDLINE
| ID: mdl-38597416
ABSTRACT
OBJECTIVE:
People with HIV (PWH) have high risk of liver fibrosis. We investigated the effect of weight gain and metabolic dysfunction-associated steatotic liver disease (MASLD) on liver fibrosis dynamics.DESIGN:
Multicenter cohort study.METHODS:
Fibrosis progression was defined as development of significant fibrosis [liver stiffness measurement (LSM) ≥8âkPa], or transition to cirrhosis (LSM ≥13âkPa), for those with significant fibrosis at baseline. Fibrosis regression was defined as transition to LSM less than 8âkPa, or to LSM less than 13âkPa for those with cirrhosis at baseline. MASLD was defined as hepatic steatosis (controlled attenuation parameter >248âdB/m) with at least one metabolic abnormality. A continuous-time multistate Markov model was used to describe transitions across fibrosis states.RESULTS:
Among 1183 PWH included from three centers (25.2% with viral hepatitis coinfection), baseline prevalence of significant fibrosis and MASLD was 14.4 and 46.8%, respectively. During a median follow-up of 2.5âyears (interquartile range 1.9-3.5), the incidence rate of fibrosis progression and regression was 2.8 [95% confidence interval (CI) 2.3-3.4] and 2.2 (95% CI 1.9-2.6) per 100 person-years, respectively. In Markov model, weight gain increased the odds of fibrosis progression [odds ratio (OR) 3.11, 95% CI 1.59-6.08], whereas weight gain (OR 0.30, 95% CI 0.10-0.84) and male sex (OR 0.32, 95% CI 0.14-0.75) decreased the odds of fibrosis regression. On multivariable Cox regression analysis, predictors of fibrosis progression were weight gain [adjusted hazard ratio (aHR) 3.12, 95% CI 1.41-6.90] and MASLD (aHR 2.72, 95% CI 1.05-7.02).CONCLUSION:
Fibrosis transitions are driven by metabolic health variables in PWH, independently of viral hepatitis coinfection and antiretroviral class therapy.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Aumento de Peso
/
Infecções por HIV
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Progressão da Doença
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Fígado Gorduroso
/
Cirrose Hepática
Limite:
Adult
/
Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
AIDS
Assunto da revista:
SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS)
Ano de publicação:
2024
Tipo de documento:
Article