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Hepatic steatosis and ‘return to health’ in HIV
Chronic liver disease and hepatic steatosis are increasingly problematic in the HIV-infected population. Hepatic steatosis is mostly associated with metabolic risk factors and the aim of this cross-sectional prospective study1 was to examine the prevalence and risk factors for severe hepatic steatosis in a large cohort of patients with HIV monoinfection.
A total of 364 patients were included: 78% male, 76% Caucasian with a mean age of 46. Metabolic blood tests and HIV disease markers were performed alongside measurement of controlled attenuation parameter (CAP), measuring the degree of ultrasound attenuation by hepatic fat by fibroscan. A total of 287 (79%) were HIV monoinfected and 95% were on antiretrovirals with 83% having undetectable HIV viral loads.
Significant hepatic steatosis defined as CAP </238 dB/m was common and observed in 41%. More severe steatosis was observed in patients with longer duration of known HIV infection (9 (0–26) vs 7 (0–29) years, p=0.019) but detectable HIV viral load did not have a statistically …
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