RESEARCH ARTICLE


Prevalence and Factors Associated with Hepatic Steatosis and Fibrosis Using Fibroscan in HIV-positive Patients Treated with Anti-retroviral (ARV) Medicines Referred to the Biggest Hospital in Tehran, 2018 to 2019



Mehrnaz Rasoulinejad1, Seyed Ahmad Seyed Alinaghi1, Masoud Reza Sohrabi2, Banafsheh Moradmand Badie3, Seyed Ali Dehghan Manshadi1, Malihe Hassan Nezhad4, *, Seyedeh Rana Khatami4, *
1 Iranian Research Center for HIV/AIDS (IRCHA), Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
2 Gastrointestinal and liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
3 National Drug and Alcohol Research Centre, UNSW, Sydney, NSW2052, Australia
4 Department of Infectious Diseases, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran


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Creative Commons License
© 2020 Rasoulinejad et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to these authors at Department of Infectious Diseases, Imam Khomeini Hospital, Tehran Iran; Tel/Fax: +98 (21) 66947984; E-mail:raana.khatami@gmail.com; malihehasannezhad@yahoo.com


Abstract

Background:

Liver injury is a characteristic feature of HIV infection, which is the second most common cause of mortality among HIV positive patients. Non-alcoholic fatty liver disease (NAFLD) has become a new concern in the management of people living with HIV (PLWH). The condition encompasses a spectrum of diseases from non-alcoholic steatohepatitis (NASH) to fibrosis and cirrhosis. The current study was to evaluate hepatic steatosis and fibrosis using fibroscan among PLWH treated with anti-retroviral (ARV) medicines.

Methods:

The present research was designed as a cross-sectional study and 100 HIV positive patients under antiretroviral treatment (ART) were enrolled in the study. All PLWH, including 49 men (49%) and 51 women (51%) (Mean age of 39.9 years), were evaluated by Transient Elastography (TE) in Imam Khomeini Hospital during 2018 and 2019.

Results:

The mean CD4 count was 610 cells/μl, 4% with CD4 < 200 cells/μl, 30% between 201 and 500cells/μl, and 66% with CD4 >500 cells/μl. Based on the TE result, 10% of patients had significant fibrosis (F2:6% and F3:4%) and most of the patients had mild fibrosis (F1:77%). A significant, direct relationship was found between HIV infection duration and fibrosis, especially in the duration of more than five years of the disease. There was no significant association between liver fibrosis and other factors (P>0.05).

Conclusion:

The presence of hepatic fibrosis and steatosis demonstrates the main health concern for PLWH mono-infection, and mainly transient elastography is recommended for HIV mono-infected patients, especially if their infection period is over five years.

Keywords: AIDS, HIV, ART, Liver fibrosis, Steatosis, Fibroscan.