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| Autori principali: | , , , , , , , , , , , |
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| Natura: | Artículo Open Access |
| Pubblicazione: |
Wiley
2024
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| Accesso online: | https://onlinelibrary.wiley.com/doi/10.1111/apt.18413 |
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- 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/