Title:Detection of Non-Alcoholic Fatty Liver Disease with Non-invasive Tools
in Turkish People Living with HIV and with Apparently Normal Liver
Function
Volume: 21
Issue: 3
Author(s): Nursel Çalık Başaran*, İlkay İdilman, Hayriye Altunay Tokuçoğlu, Mehmet Ruhi Onur, Meliha Çağla Sönmezer, Lale Özışık, Muşturay Karçaaltıncaba, Ahmet Çağkan İnkaya and Serhat Ünal
Affiliation:
- Division of General Internal Medicine, Internal Medicine Department, Medical Faculty, Hacettepe University, Ankara, Turkey
Keywords:
HIV, PLWH, fatty liver, NAFLD, liver fibrosis, MR elastography, US elastography.
Abstract:
Background: Non-alcoholic fatty liver disease (NAFLD) has become a significant cause of
mortality and morbidity in people living with HIV.
Objective: We aimed to investigate NAFLD presence by magnetic resonance imaging (MRI) methods,
including MRI-derived proton density fat fraction (MRI-PDFF) and MRE, and ultrasound elastography
among Turkish people living with HIV (PLWH), and identify factors correlated with fatty liver.
Methods: We included 57 PLWH attending outpatient clinics on antiretroviral therapy (ART) for
more than six months, without HBV/HCV co-infection, significant alcohol consumption, active opportunistic
infection, previously diagnosed hepatobiliary disease, T2DM, and hyperlipidemia. We
performed MRI, MRE, and US elastography on all participants.
Results: The mean age of the participants (M/F, 47/10) was 41.7± 12 years. The median duration of
HIV infection was 3 (0.5-19 years) years. The mean MRI-PDFF was 4.4 ± 3.8 %, and 11 had fatty
liver. The mean MRE value was 2.27 ± 0.6 kPa, inflammation was present in 16, and 4 participants
had values consistent with fibrosis. The mean US elastography of the study population was 4.1±2.4
kPa. The mean right and left CCA intima-media of the study population was 0.65± 0.23 mm and
0.66± 0.25 mm; 16 had increased intima-media thickness. In patients with fatty liver, a significant
positive correlation was present between MRE and CCA intima-media thickness (rs=0.82, p:0.006 for
MRE-left CCA; r=0.68, p=0.042 for MRE-right CCA).
Conclusion: We demonstrated that even a significant proportion of PLWH individuals with normal
transaminase levels have fatty liver. Future prospective trials are warranted to understand and mitigate
the risk factors, course of NAFLD, and accurate non-invasive tests, predicting fibrosis in people living
with HIV.
