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Metabolic causes of liver disease among adults living with HIV from low‐ and middle‐income countries: a cross‐sectional study

Journal of the International AIDS Society, 2024-04, Vol.27 (4), p.e26238-n/a [Peer Reviewed Journal]

2024 The Authors. published by John Wiley & Sons Ltd on behalf of International AIDS Society. ;2024 The Authors. Journal of the International AIDS Society published by John Wiley & Sons Ltd on behalf of International AIDS Society. ;2024. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;ISSN: 1758-2652 ;EISSN: 1758-2652 ;DOI: 10.1002/jia2.26238 ;PMID: 38566493

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Title:
Metabolic causes of liver disease among adults living with HIV from low‐ and middle‐income countries: a cross‐sectional study
Author: Plaisy, Marie Kerbie ; Minga, Albert K. ; Wandeler, Gilles ; Murenzi, Gad ; Samala, Niharika ; Ross, Jeremy ; Lopez, Alvaro ; Mensah, Ephrem ; Waal, Renée ; Kuniholm, Mark H. ; Diero, Lameck ; Salvi, Sonali ; Moreira, Rodrigo ; Attia, Alain ; Mandiriri, Ardele ; Shumbusho, Fabienne ; Goodrich, Suzanne ; Rupasinghe, Dhanushi ; Alarcon, Paola ; Maruri, Fernanda ; Perrazo, Hugo ; Jaquet, Antoine
Subjects: Acquired immune deficiency syndrome ; Adult ; AIDS ; Antiretroviral agents ; antiretroviral therapy ; Baseline studies ; Cross-Sectional Studies ; Developing Countries ; Diabetes Mellitus, Type 2 ; Dyslipidemias - complications ; Dyslipidemias - epidemiology ; Female ; HIV ; HIV acquisition ; HIV Infections - complications ; HIV Infections - drug therapy ; HIV Infections - epidemiology ; Human immunodeficiency virus ; Humans ; Hypertension ; Infant, Newborn ; Laboratory tests ; Liver ; Liver Cirrhosis - complications ; Liver Cirrhosis - epidemiology ; liver disease ; liver fibrosis ; low‐ and middle‐income countries ; Male ; Metabolic disorders ; Middle Aged ; Mortality ; Obesity ; Obesity - epidemiology ; Overweight - complications ; Regression models ; Risk factors ; Sexually transmitted diseases ; Spatial variations ; STD ; Vibration
Is Part Of: Journal of the International AIDS Society, 2024-04, Vol.27 (4), p.e26238-n/a
Description: Introduction Liver disease is a leading cause of morbidity and mortality among persons living with HIV (PLHIV). While chronic viral hepatitis has been extensively studied in low‐ and middle‐income countries (LMICs), there is limited information about the burden of metabolic disorders on liver disease in PLHIV. Methods We conducted a cross‐sectional analysis of baseline data collected between October 2020 and July 2022 from the IeDEA‐Sentinel Research Network, a prospective cohort enrolling PLHIV ≥40 years on antiretroviral treatment (ART) for ≥6 months from eight clinics in Asia, Americas, and central, East, southern and West Africa. Clinical assessments, laboratory testing on fasting blood samples and liver stiffness measurement (LSM)/controlled attenuation parameter (CAP) by vibration‐controlled transient elastography were performed. Multivariable logistic regression models assessed factors associated with liver fibrosis (LSM ≥7.1 kPa) and steatosis (CAP ≥248 dB/m). Population attributable fraction (PAF) of each variable associated with significant liver fibrosis was estimated using Levin's formula. Results Overall, 2120 PLHIV (56% female, median age 50 [interquartile range: 45−56] years) were included. The prevalence of obesity was 19%, 12% had type 2 diabetes mellitus (T2DM), 29% had hypertension and 53% had dyslipidaemia. The overall prevalence of liver fibrosis and steatosis was 7.6% (95% confidence interval [CI] 6.1−8.4) and 28.4% (95% CI 26.5−30.7), respectively, with regional variability. Male sex at birth (odds ratio [OR] 1.62, CI 1.10−2.40), overweight/obesity (OR = 2.50, 95% CI 1.69−3.75), T2DM (OR 2.26, 95% CI 1.46−3.47) and prolonged exposure to didanosine (OR 3.13, 95% CI 1.46−6.49) were associated with liver fibrosis. Overweight/obesity and T2DM accounted for 42% and 11% of the PAF for liver fibrosis, while HBsAg and anti‐HCV accounted for 3% and 1%, respectively. Factors associated with steatosis included overweight/obesity (OR 4.25, 95% CI 3.29−5.51), T2DM (OR 2.06, 95% CI 1.47−2.88), prolonged exposure to stavudine (OR 1.69, 95% CI 1.27−2.26) and dyslipidaemia (OR 1.68, 95% CI 1.31−2.16). Conclusions Metabolic disorders were significant risk factors for liver disease among PLHIV in LMICs. Early recognition of metabolic disorders risk factors might be helpful to guide clinical and lifestyle interventions. Further prospective studies are needed to determine the causative natures of these findings.
Publisher: Switzerland: John Wiley & Sons, Inc
Language: English
Identifier: ISSN: 1758-2652
EISSN: 1758-2652
DOI: 10.1002/jia2.26238
PMID: 38566493
Source: Freely Accessible Journals
Wiley Blackwell Open Access Collection
Journals@Ovid Open Access Journal Collection Rolling
MEDLINE
PubMed Central
ROAD: Directory of Open Access Scholarly Resources
ProQuest Central
DOAJ Directory of Open Access Journals

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Metabolic causes of liver disease among adults living with HIV from low‐ and middle‐income countries: a cross‐sectional study

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