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Associations of Hepatosteatosis with Cardiovascular Disease in HIV Positive and HIV Negative Patients: The Liverpool HIV-Heart Project

Heseltine, T, Murray, S, Ortega Martorell, S, Olier-Caparroso, I, Lip, GYH and Khoo, S Associations of Hepatosteatosis with Cardiovascular Disease in HIV Positive and HIV Negative Patients: The Liverpool HIV-Heart Project. Journal of Acquired Immune Deficiency Syndromes. ISSN 1525-4135 (Accepted)

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Abstract

Hepatosteatosis (HS) is the most common cause of liver disease in patients living with HIV (PLWHIV), affecting between 13 to 65% (1–3) individuals. HS describes hepatic ectopic fat accumulation and is present when it affects >5% of the liver by weight. HS encompasses a spectrum of clinically entities including non-alcoholic fatty liver disease (NAFLD). The prevalence of HS is under reported. Histologically, progressive hepatic fat accumulation is associated with lipotoxicity and chronic inflammation, progressing in many cases to cirrhotic liver disease, and a threefold increase in mortality (4). The relationship of obesity, insulin resistance, type II diabetes and hepatosteatosis (HS) is well defined in non-HIV populations (5). The estimated prevalence of NAFLD in the United States is predicted to reach 33% of the adult population by 2030 (6). PLWHIV have unique risk factors for the development of HS compared to non-HIV populations. They have been shown to develop lean NAFLD, defined as NAFLD in BMI< 25Kg/m2 , at increased rates compared to non-HIV populations (7). The complex interplay of viral related factors, antiretroviral (ARV) medications and chronic inflammation may cause PLWHIV to be more susceptible to the development of HS. Liver disease represents a huge source of morbidity and mortality in PLWHIV with up to 13% of deaths in the Data Collection on Adverse events of Anti-HIV Drugs (D:A:D) cohort attributable to liver disease (8). In both HIV-positive and HIV-negative populations dyslipidaemia, insulin resistance and overt type II diabetes are strongly associated with the presence of HS. HS has been shown to be associated with CVD in HIV-negative populations (9–11) although this is not universal (12–14). Given the increasing burden of HS in HIV-positive populations 3 we sought to examine if HS was independently associated with CVD in HIV-positive compared to HIV-negative populations.

Item Type: Article
Uncontrolled Keywords: 1103 Clinical Sciences, 1117 Public Health and Health Services
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions: Computer Science & Mathematics
Nursing & Allied Health
Publisher: Lippincott, Williams & Wilkins
Date Deposited: 15 Apr 2021 08:42
Last Modified: 04 Sep 2021 05:36
URI: https://researchonline.ljmu.ac.uk/id/eprint/14803

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