Impact of Nonalcoholic Fatty Liver Disease on the Survival of People Living With HIV

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Autores principales: Juan Macias, Mario Frias, Juan Antonio Pineda, Diana Corona‐Mata, Anais Corma‐Gomez, Antonio Rivero‐Juarez, Marta Santos, Miguel García‐Deltoro, Antonio Rivero, Carmen Ricart‐Olmos, Alejandro Gonzalez‐Serna, Luis Miguel Real
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Publicado: Wiley 2024
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author Juan Macias
Mario Frias
Juan Antonio Pineda
Diana Corona‐Mata
Anais Corma‐Gomez
Antonio Rivero‐Juarez
Marta Santos
Miguel García‐Deltoro
Antonio Rivero
Carmen Ricart‐Olmos
Alejandro Gonzalez‐Serna
Luis Miguel Real
author_facet Juan Macias
Mario Frias
Juan Antonio Pineda
Diana Corona‐Mata
Anais Corma‐Gomez
Antonio Rivero‐Juarez
Marta Santos
Miguel García‐Deltoro
Antonio Rivero
Carmen Ricart‐Olmos
Alejandro Gonzalez‐Serna
Luis Miguel Real
Juan Macias
Mario Frias
Juan Antonio Pineda
Diana Corona‐Mata
Anais Corma‐Gomez
Antonio Rivero‐Juarez
Marta Santos
Miguel García‐Deltoro
Antonio Rivero
Carmen Ricart‐Olmos
Alejandro Gonzalez‐Serna
Luis Miguel Real
collection Wiley Open Access
contents Impact of Nonalcoholic Fatty Liver Disease on the Survival of People Living With HIV Juan Macias Mario Frias Juan Antonio Pineda Diana Corona‐Mata Anais Corma‐Gomez Antonio Rivero‐Juarez Marta Santos Miguel García‐Deltoro Antonio Rivero Carmen Ricart‐Olmos Alejandro Gonzalez‐Serna Luis Miguel Real Alimentary Pharmacology & Therapeutics ABSTRACTBackgroundNonalcoholic fatty liver disease (NAFLD) is an increasing concern for people living with HIV (PLWH). However, information on the impact of NAFLD on the prognosis of PLWH is very scarce.AimsTo investigate the influence of NAFLD on the overall and liver‐related mortality in PLWH.MethodsPLWH followed in three Spanish centres were included in a prospective cohort at the date of the first transient elastography evaluation. Survival data were recorded, and the causes of death were centrally monitored. The risk of all‐cause death and liver‐related death was evaluated by applying time‐to‐event analyses.ResultsA total of 2151 PLWH were included in the cohort and followed for a median (Q1–Q3) of 7.3 (3.5–10.4) years. There were 174 (8.1%) deaths. The probability of overall death and liver‐related death was associated with liver stiffness measurement (LSM) and with FibroScan‐AST (FAST) score. Among 844 PLWH with potential for NALFD, LSM was independently associated with all‐cause mortality (adjusted hazard ratio [AHR], by 1 kPa increase: 1.06; 95% confidence interval [95% CI]: 1.04–1.08; p < 0.001). In a separate model and after adjustment, FAST score ≥ 0.67 was related to survival (AHR: 1.87; 95% CI: 1.40–2.50; p < 0.001). The AUROC (95% CI) of the models were based on LSM, 0.812 (0.739–0.885); and FAST, 0.825 (0.753–0.897) (p = 0.386).ConclusionsFor PLWH, advanced liver fibrosis increases the risk of overall death and liver‐related death. LSM and the FAST score are similar predictors of survival for PLWH with potential for NAFLD. 10.1111/apt.18413 http://creativecommons.org/licenses/by-nc-nd/4.0/
doi_str_mv 10.1111/apt.18413
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spellingShingle Impact of Nonalcoholic Fatty Liver Disease on the Survival of People Living With HIV
Juan Macias
Mario Frias
Juan Antonio Pineda
Diana Corona‐Mata
Anais Corma‐Gomez
Antonio Rivero‐Juarez
Marta Santos
Miguel García‐Deltoro
Antonio Rivero
Carmen Ricart‐Olmos
Alejandro Gonzalez‐Serna
Luis Miguel Real
Alimentary Pharmacology & Therapeutics
Impact of Nonalcoholic Fatty Liver Disease on the Survival of People Living With HIV Juan Macias Mario Frias Juan Antonio Pineda Diana Corona‐Mata Anais Corma‐Gomez Antonio Rivero‐Juarez Marta Santos Miguel García‐Deltoro Antonio Rivero Carmen Ricart‐Olmos Alejandro Gonzalez‐Serna Luis Miguel Real Alimentary Pharmacology & Therapeutics ABSTRACTBackgroundNonalcoholic fatty liver disease (NAFLD) is an increasing concern for people living with HIV (PLWH). However, information on the impact of NAFLD on the prognosis of PLWH is very scarce.AimsTo investigate the influence of NAFLD on the overall and liver‐related mortality in PLWH.MethodsPLWH followed in three Spanish centres were included in a prospective cohort at the date of the first transient elastography evaluation. Survival data were recorded, and the causes of death were centrally monitored. The risk of all‐cause death and liver‐related death was evaluated by applying time‐to‐event analyses.ResultsA total of 2151 PLWH were included in the cohort and followed for a median (Q1–Q3) of 7.3 (3.5–10.4) years. There were 174 (8.1%) deaths. The probability of overall death and liver‐related death was associated with liver stiffness measurement (LSM) and with FibroScan‐AST (FAST) score. Among 844 PLWH with potential for NALFD, LSM was independently associated with all‐cause mortality (adjusted hazard ratio [AHR], by 1 kPa increase: 1.06; 95% confidence interval [95% CI]: 1.04–1.08; p < 0.001). In a separate model and after adjustment, FAST score ≥ 0.67 was related to survival (AHR: 1.87; 95% CI: 1.40–2.50; p < 0.001). The AUROC (95% CI) of the models were based on LSM, 0.812 (0.739–0.885); and FAST, 0.825 (0.753–0.897) (p = 0.386).ConclusionsFor PLWH, advanced liver fibrosis increases the risk of overall death and liver‐related death. LSM and the FAST score are similar predictors of survival for PLWH with potential for NAFLD. 10.1111/apt.18413 http://creativecommons.org/licenses/by-nc-nd/4.0/
title Impact of Nonalcoholic Fatty Liver Disease on the Survival of People Living With HIV
topic Alimentary Pharmacology & Therapeutics
url https://onlinelibrary.wiley.com/doi/10.1111/apt.18413