Rafiq N, Stepanova M, Lam B, Nader F, Srishord M, Younossi ZM

Language: English
References: 24
Page: 60-64
PDF size: 78.31 Kb.

ABSTRACT

Introduction. Chronic liver disease (CLD) is becoming a major cause of mortality in patients who are positive with human immunodeficiency virus (HIV). Our aim was to assess the prevalence of CLD in HIV+ individuals. Material and methods. We utilized the National Health and Nutrition Examination Survey (1999-2008) to assess the association of CLD with HIV infection. In eligible participants (18-49 years), HIV infection was defined as positive anti-HIV by enzyme immunoassay further confirmed by Western blot. The diagnosis of CLD included chronic hepatitis C (CH-C), alcohol-related liver disease (ALD) and non-alcoholic fatty liver disease (NAFLD). Clinic-demographic and laboratory parameters were used to assess differences between those with and without HIV infection. Results. 14,685 adults were included. Of those, 0.43 ± 0.08% were HIV-positive and 13.8% had evidence of CLD, including 26.3% in HIV-positive individuals and 13.7% in HIV-negative controls (p = 0.0341). In the U.S. population, independent predictors of CLD included HIV positivity [OR = 1.96 (1.02-3.77), p = 0.04], older age [OR = 1.03 (1.02-1.03), p ‹ 0.0001], male gender [OR = 2.15 (1.89-2.44), p ‹ 0.0001] and obesity [OR = 2.10 (1.82-2.43), p ‹ 0.0001], while African American race/ethnicity was associated with lower risk for CLD [OR = 0.68 (0.58-0.80), p ‹ 0.0001]. Conclusions. CLD is common in HIV positive individuals. With successful long term treatment of HIV, management of CLD will continue to remain very important in these patients.

REFERENCES

1. http://www.who.int/hiv/pub/progress_report2011/en/ index.html Progress report 2011: Global HIV/AIDS response -Epidemic update and health sector progress towards universal access. Accessed May 1, 2012.

2. Hammer SM, Squires KE, Hughes MD, et al. A controlled trial of two nucleoside analogues plus indinavir in persons with human immunodeficiency virus infection and CD4 cell counts of 200 per cubic millimeter or less. AIDS Clinical Trials Group 320 Study Team. N Engl J Med 1997; 337: 725-33.

3. http://www.cdc.gov/media/pressrel/r981007.htm Accessed May 2, 2012.

4. Weber R, Sabin CA, Friis-Moller N, et al. Liver-related deaths in persons infected with the human immunodeficiency virus: the D: A: D study. Arch Intern Med 2006; 166: 1632-41.

5. Palella FJJr, Baker RK, Moorman AC, et al. Mortality in the highly active antiretroviral therapy era: changing causes of death and disease in the HIV outpatient study. J Acquir Immune Defic Syndr 2006; 43: 27-34.

6. Data Collection on Adverse Events of Anti-HIV drugs (D:A:D) Study Group, Smith C Group TDCoAEoA-HIVdS: factors associated with specific causes of death amongst HIV-positive individuals in the D: A: D study. AIDS 2010; 24: 1537-48.

7. Laurence JC, Hepatitis A and B immunizations of individuals infected with human immunodeficiency virus. Am J Med 2005; 118(Suppl. 10A):75S.

8. Brooks G. Prevention of viral hepatitis in HIV co-infection. J Hepatol 2006; 44(1 Suppl.): S104-7.

9. Benhamou Y, Bochet M, Di Martino V, et al. Liver fibrosis progression in human immunodeficiency virus and hepatitis C virus coinfected patients. The Multivirc Group. Hepatology 1999; 30: 1054-8.

10. Bonnard P, Lescure FX, Amiel C, et al. Documented rapid course of hepatic fibrosis between two biopsies in patients coinfected by HIV and HCV despite high CD4 cell count. J Viral Hepat 2007; 14: 806-11.

11. Thio CL, Seaberg E.C, Skolasky R Jr, et al. HIV-1, hepatitis B virus, and risk of liver-related mortality in the Multicenter Cohort Study (MACS). Lancet 2002; 360: 1921-6.

12. Thomas DL, Astemborski J, Rai RM, Anania FA, Schaeffer M, Galai N, et al. The natural history of hepatitis C virus infection: host, viral, and environmental factors. JAMA 2000; 284(4): 450-6.

13. Crum-Cianflone N, Dilay A, Collins G, et al. Nonalcoholic fatty liver disease among HIV-infected persons. J Acquir Immune Defic Syndr 2009; 50: 464-73.

14. Marchesini G, Forlani G. NASH: from liver diseases to metabolic disorders and back to clinical hepatology. Hepatol 2002; 35: 497-9.

15. Lemoine M, Serfaty L, Capeau J. From nonalcoholic fatty liver to nonalcoholic steatohepatitis and cirrhosis in HIVinfected patients: diagnosis and management. Curr Opin Infect Dis 2012; 25(1): 10-16.

16. Guaraldi G, Squillace N, Stentarelli C, et al. Nonalcoholic fatty liver disease in HIV-infected patients referred to a metabolic clinic: prevalence, characteristics, and predictors. Clin Infect Dis 2008; 47: 250-7.

17. Akhtar MA, Mathieson K, Arey B, et al. Hepatic histopathology and clinical characteristics associated with antiretroviral therapy in HIV patients without viral hepatitis. Eur J Gastroenterol Hepatol 2008; 20: 1194-204.

18. Caron-Debarle M, Lagathu C, Boccara F, et al. HIV-associated lipodystrophy: from fat injury to premature aging. Trends Molec Med 2010; 16: 218-29.

19. Chander G, Lau B, Moore RD. Hazardous alcohol use: a risk factor for non-adherence and lack of suppression in HIV infection. J Acquir Immune Defic Syndr 2006; 43: 411-17.

20. Bonacini M. Alcohol use among patients with HIV infection. Ann Hepatol 2011; 10: 502-7.

21. Centers for Disease Control and Prevention (CDC). National Center for Health Statistics (NCHS). National Health and Nutrition Examination Survey Analytic Guidelines. Hyattsville, MD: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2005.

22. http://www.cdc.gov/nchs/nhanes/nhanes2007-2008/ HIV_E.htm. Accessed October 4, 2012.

23. Jensen DM. A new era of hepatitis C therapy begins. N Engl J Med 2011; 364(13): 1272-4.

24. Zeuzem S, Andreone P, Pol S, Lawitz E, Diago M, Roberts S, et al. Telaprevir for retreatment of HCV infection. N Engl J Med 2011; 364(25): 2417-28.