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Liver steatosis and metabolic dysfunction-associated fatty liver disease among HIV-positive and negative adults in urban Zambia.
Chihota, Belinda Varaidzo; Riebensahm, Carlotta; Muula, Guy; Sinkala, Edford; Chilengi, Roma; Mulenga, Lloyd; Bosomprah, Samuel; Vinikoor, Michael J; Bolton-Moore, Carolyn; Egger, Matthias; Rauch, Andri; Berzigotti, Annalisa; Wandeler, Gilles.
Afiliación
  • Chihota BV; Centre for Infectious Disease Research in Zambia, Lusaka, Zambia belinda.chihota@cidrz.org.
  • Riebensahm C; Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
  • Muula G; Graduate School of Health Sciences, University of Bern, Bern, Switzerland.
  • Sinkala E; Graduate School of Health Sciences, University of Bern, Bern, Switzerland.
  • Chilengi R; Department of Infectious Diseases, Bern University Hospital, University of Bern, Bern, Switzerland.
  • Mulenga L; Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.
  • Bosomprah S; Department of Internal Medicine, University Teaching Hospital, Lusaka, Zambia.
  • Vinikoor MJ; Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.
  • Bolton-Moore C; Ministry of Health, Lusaka, Zambia.
  • Egger M; Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.
  • Rauch A; Department of Biostatistics, University of Ghana, Accra, Ghana.
  • Berzigotti A; Department of Medicine, The University of Alabama, Birmingham, Alabama, USA.
  • Wandeler G; Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.
Article en En | MEDLINE | ID: mdl-35831020
ABSTRACT

INTRODUCTION:

The growing importance of non-communicable diseases (NCDs) and high HIV prevalence in urban African settings may increase the burden of metabolic dysfunction-associated fatty liver disease (MAFLD). We assessed liver steatosis among HIV-positive and negative adults in urban Zambia.

METHODS:

Adults 30 years and older who were newly diagnosed with HIV, or tested HIV-negative at two primary care clinics in Lusaka, Zambia, were assessed for liver steatosis. Cardiometabolic data were collected through comprehensive clinical and laboratory assessments. Transient elastography was performed to measure controlled-attenuation parameter (≥248 dB/m). We used multivariable logistic regression models to determine the factors associated with the presence of steatosis.

RESULTS:

We enrolled 381 patients, including 154 (40%) antiretroviral therapy-naïve people living with HIV (PLWH) with a median CD4+ count of 247 cells/mm3 and a mean body mass index (BMI) of 23.8 kg/m2. Liver steatosis was observed in 10% of participants overall and was more common among HIV-negative adults than in PLWH (15% vs 3%). The proportion of patients with steatosis was 25% among obese (BMI ≥30 kg/m2) participants, 12% among those overweight (BMI 25-29.9 kg/m2), and 7% among those with a BMI <25 kg/m2. Among patients with a fasting glucose ≥7 mmol/L or confirmed diabetes, 57% had liver steatosis. In multivariable analyses, HIV status (adjusted odds ratio (aOR) 0.18, 95% CI 0.06 to 0.53), confirmed diabetes or elevated fasting glucose (aOR 3.92, 95% CI 1.57 to 9.78) and elevated blood pressure (aOR 2.95, 95% CI 1.34 to 6.48) were associated with steatosis. The association between BMI>25 kg/m2 and liver steatosis was attenuated after adjustment for potential confounders (aOR 1.96, 95% CI 0.88-4.40). Overall, 21 (9%) participants without HIV and 4 (3%) with HIV met the criteria for MAFLD. Among individuals with liver steatosis, 65% (95% CI 49% to 80%) fulfilled criteria of MAFLD, whereas 15 (39%) of them had elevated transaminases and 3 (8%) F2-F4 fibrosis.

CONCLUSIONS:

The prevalence of liver steatosis in this urban cohort of HIV-positive and negative adults in Zambia was low, despite a large proportion of patients with high BMI and central obesity. Our study is among the first to report data on MAFLD among adults in Africa, demonstrating that metabolic risk factors are key drivers of liver steatosis and supporting the adoption of the criteria for MAFLD in African populations.
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Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Infecciones por VIH / Hígado Graso Tipo de estudio: Etiology_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Humans País/Región como asunto: Africa Idioma: En Revista: BMJ Open Gastroenterol Año: 2022 Tipo del documento: Article País de afiliación: Zambia

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Infecciones por VIH / Hígado Graso Tipo de estudio: Etiology_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Humans País/Región como asunto: Africa Idioma: En Revista: BMJ Open Gastroenterol Año: 2022 Tipo del documento: Article País de afiliación: Zambia