TY - JOUR
T1 - Prevalence and Characteristics of Nonalcoholic Fatty Liver Disease and Fibrosis in People Living With HIV Monoinfection
T2 - A Systematic Review and Meta-analysis
AU - Kalligeros, Markos
AU - Vassilopoulos, Athanasios
AU - Shehadeh, Fadi
AU - Vassilopoulos, Stephanos
AU - Lazaridou, Ingrid
AU - Mylonakis, Eleftherios
AU - Promrat, Kittichai
AU - Wands, Jack R.
N1 - Funding Information:
Markos Kalligeros: Writing – review & editing, Writing –original draft, Methodology, Investigation, Formal analysis, Conceptualization. Athanasios Vassilopoulos: Writing – review & editing, Investigation. Fadi Shehadeh: Writing – review & editing, Methodology, Formal analysis, Data curation. Stephanos Vassilopoulos: Investigation, Writing – review & editing. Ingrid Lazaridou: Writing – review & editing, Investigation. Eleftherios Mylonakis: Writing – review & editing, Supervision, Conceptualization. Kittichai Promrat: Writing – review & editing, Supervision. Jack R Wands: Writing – review & editing, Supervision.
Publisher Copyright:
© 2023 AGA Institute
PY - 2023/7
Y1 - 2023/7
N2 - Background and Aims: Liver disease remains a leading cause of morbidity and mortality among people living with HIV (PLWH). Emerging data suggest that PLWH are at high risk for developing nonalcoholic fatty liver disease (NAFLD). The aim of this review is to examine the current literature and provide an accurate estimate of the prevalence of NAFLD, nonalcoholic steatohepatitis (NASH), and fibrosis, and identify potential risk factors for NAFLD in PLWH. Methods: We searched PubMed and Embase databases to identify studies reporting the prevalence of NAFLD and/or fibrosis in PLWH monoinfection. We performed a random effects meta-analysis of proportions to estimate the pooled prevalence of NAFLD, NASH, and fibrosis among PLWH monoinfection. We also examined potential risk factors for NAFLD by comparing characteristics of PLWH monoinfection with and without NAFLD. Results: A total of 43 studies, reporting data for 8230 patients, met our eligibility criteria and were included in the meta-analysis. Based on imaging studies the overall pooled prevalence of NAFLD and moderate liver fibrosis (METAVIR ≥ F2) among PLWH monoinfection was 33.9% (95% confidence interval [CI], 29.67%–38.39%), and 12.00% (95% CI, 10.02%–14.12%), respectively. Based on biopsy studies, prevalence of NASH and significant liver fibrosis (stage ≥F2 on histology) was 48.77% (95% CI, 34.30%–63.34%) and 23.34% (95% CI, 14.98%–32.75%), respectively. Traditional metabolic syndrome and HIV-related factors were associated with NAFLD in PLWH. Conclusions: Our study confirms that the burden of NAFLD, NASH, and fibrosis is high among PLWH monoinfection. Prospective longitudinal studies are needed to delineate NAFLD, NASH, and fibrosis risk factors, and identify early interventions and new therapies for NAFLD in this population.
AB - Background and Aims: Liver disease remains a leading cause of morbidity and mortality among people living with HIV (PLWH). Emerging data suggest that PLWH are at high risk for developing nonalcoholic fatty liver disease (NAFLD). The aim of this review is to examine the current literature and provide an accurate estimate of the prevalence of NAFLD, nonalcoholic steatohepatitis (NASH), and fibrosis, and identify potential risk factors for NAFLD in PLWH. Methods: We searched PubMed and Embase databases to identify studies reporting the prevalence of NAFLD and/or fibrosis in PLWH monoinfection. We performed a random effects meta-analysis of proportions to estimate the pooled prevalence of NAFLD, NASH, and fibrosis among PLWH monoinfection. We also examined potential risk factors for NAFLD by comparing characteristics of PLWH monoinfection with and without NAFLD. Results: A total of 43 studies, reporting data for 8230 patients, met our eligibility criteria and were included in the meta-analysis. Based on imaging studies the overall pooled prevalence of NAFLD and moderate liver fibrosis (METAVIR ≥ F2) among PLWH monoinfection was 33.9% (95% confidence interval [CI], 29.67%–38.39%), and 12.00% (95% CI, 10.02%–14.12%), respectively. Based on biopsy studies, prevalence of NASH and significant liver fibrosis (stage ≥F2 on histology) was 48.77% (95% CI, 34.30%–63.34%) and 23.34% (95% CI, 14.98%–32.75%), respectively. Traditional metabolic syndrome and HIV-related factors were associated with NAFLD in PLWH. Conclusions: Our study confirms that the burden of NAFLD, NASH, and fibrosis is high among PLWH monoinfection. Prospective longitudinal studies are needed to delineate NAFLD, NASH, and fibrosis risk factors, and identify early interventions and new therapies for NAFLD in this population.
KW - HIV
KW - HIV Monoinfection
KW - Meta-analysis
KW - NAFLD
KW - PLWH
KW - Liver/pathology
KW - Prevalence
KW - Prospective Studies
KW - Liver Cirrhosis/pathology
KW - HIV Infections/complications
KW - Humans
KW - Non-alcoholic Fatty Liver Disease/complications
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UR - http://www.scopus.com/inward/citedby.url?scp=85149765869&partnerID=8YFLogxK
U2 - 10.1016/j.cgh.2023.01.001
DO - 10.1016/j.cgh.2023.01.001
M3 - Review article
C2 - 36642292
AN - SCOPUS:85149765869
SN - 1542-3565
VL - 21
SP - 1708
EP - 1722
JO - Clinical Gastroenterology and Hepatology
JF - Clinical Gastroenterology and Hepatology
IS - 7
ER -