Table 1.
Prevalence of NAFLD and its risk factors in studies of patients with HIV.
| Reference | n | Age* | M:F | BMI | Race, Nationality, or Ethnicity | Method of Diagnosis | Genotype (%) | NAFLD (%) | Identified Risk Factors | Factors that did not significantly contribute |
|---|---|---|---|---|---|---|---|---|---|---|
| Rafiq et al., 2013(49) | 14,685: 79 HIV+ 14,606 HIV− |
HIV+: 38 HIV− 35 |
3:1, HIV+ 1:1 HIV− |
n/a | HIV+: 31% White; 52% Black HIV−: 67% White, 12% Black |
Men: ALT>40, AST>37 Women: ALT/AST >31 |
Unknown | HIV+ 19.3 HIV− 10.9 |
HIV | |
| Kardashian et al., 2017(50) | 228: 121 HIV+ 107 HIV− |
35–70 | 3:2 | n/a | US: (race/ethnicity n/a) | Liver Fat Fraction Measured on Magnetic Resonance Imaging and Spectroscopy | Unknown |
Women: HIV+ 1.9 HIV− 3.1 Men: HIV+ 4.6 HIV− 4.1 |
high VAT, insulin resistance (HIV+) | CD4+ cell count, HIV RNA level, ART |
| Price et al., 2014(51) | 719: 465 HIV+ 254 HIV− |
53 | 100:0 | 25.8 | 56% White | Liver-spleen attenuation values of <1.1 on Non-contrast Computed Tomography |
PNPL A3-60 CC 35 GC 4.4 GG |
HIV+ 13 HIV− 19 |
VAT, insulin resistance, PNPLA3 non-CC genotype (in HIV+), dideoxynucle oside analogs (in HIV+) | GCKR (rs780094), LYPLAL1 (rs12137855) and PPP1R3b (rs4240624) HIV-PNPLA3 (rs738409) |
| Nishijima et al., 2014 (52) | 435 HIV+ | >17 | n/a | n/a | Japan | Abdominal Ultrasound | Unknown | 31 | BMI, dyslipidemia, higher ALT:AST ratio | Dideoxynucle oside analogues, duration of ART |
| Scheiner et al., 2015(53) | 177 HIV/HCV | 39 | 3:1 | 23.1 | Austria (race/ethnicity n/a) | Liver biopsy, Transient Elastography with Controlled Attenuation Parameter |
PNPL A3-57.8 CC: 37.3 GC: 5.1 GG: IL28B-10.2 TT: 57.1 TC: 32.2 CC |
n/a | HCV-GT3, BMI, age | PNPLA3, L28B-genotype |
| Morse et al., 2015(54) | 62 HIV+ | n/a | n/a | n/a | US: (race/ethnicity n/a) | Liver Biopsy | Unknown | 55 (NASH) | PNPLA3 minor allele, insulin resistance, obesity | Duration of HIV or ART, specific ART, history of OI, immune status, or duration of AST/ALT elevation |
| Jimenez -Sousa et al., 2016(55) | 215 HIV/HCV | n/a | n/a | n/a | Spain | Liver Biopsy | PNPL A3-0.05 CC: 0.38 GC: 0.57G G |
NAFLD CC: 70 CG: 64 GG: 57 Fibrosis >3 CC: 0 CG: 19 GG:: 25 |
n/a | n/a |
| Crum-Cianflone et al., 2009(56) | 216 HIV | 40+/−11 | 9:1 | 26 | 48% White, 27% Black, 14% Hispanic, 11% other | Liver Biopsy | Unknown | White: 35 African Americans: 31 |
BMI, waist circumference, lower HDL levels, higher triglyceride levels, use of lipid- lowering medication, metabolic syndrome | CD4 cell count, HIV-1 RNA, duration of HIV infection and ART |
| Guaraldi et al., 2008(57) | 225 HIV | 48 | 3:1 | 23.2 | Italian | Liver-spleen attenuation values of <1.1 on Non-contrast Computed Tomography | Unknown | Infected: 37 | Higher ALT:AST ratio male sex, greater waist circumference, longer NRTI exposure | Coronary artery calcium scores, diabetes |
| Lui et al., 2016(58) | 240: 80 HIV+ 160 HIV− |
54+/−11 | 9:1 | n/a | Chinese | Transient Elastography and Proton Magnetic Resonance Spectroscopy | Unknown | HIV+: 28.7 HIV−: 27.5 |
n/a | n/a |
| Macias et al., 2015(59) | 431: 275 HIV/HCV 156 HIV+ | 42–50 | 4:1 | 23.3 | Spain | Transient Elastography | Unknown | NAFLD: 41.5 NASH: 28.3 SAMM50: TT: 60.5 CT/CC: 39.6 rs12743824: AC/AA: 37.8 CC: 49.2 |
Dominant SAMM50 rs738491-T allele | dominant LPPR4 rs12743824-A allele |
*
Mean, median, or range; n/a= not available
NAFLD, non-alcoholic fatty liver disease; NASH, non-alcoholic steatohepatitis; VAT, visceral adipose tissue; BMI, body mass index; NRTI, nucleotide reverse transcriptase inhibitor; ART, antiretroviral therapy; OI, opportunistic infection; AST, aspartate aminotransferase; ALT, alanine aminotransferase