Journal of Gastrointestinal Disorders and Liver Function

Objective: HIV-infected patients are at an increased risk of developing Hepatic Steatosis (HS), which may progress to nonalcoholic steatohepatitis. The aim of this study was to evaluate HS in Japanese HIV-infected patients using a novel technique called Controlled Attenuation Parameter (CAP). Methods: Sixty HIV-infected outpatients were included in this study and underwent transient elastography with CAP. Significant Hepatic Steatosis (SHS) was defined using the previously established CAP cut-off of 232dB/m. The relationships between SHS and blood chemistry, HBV/HCV co-infection and antiretroviral drugs were analyzed in HIV-infected patients. Results: The mean CAP level was 228dB/m. SHS was detected in 25 patients (42.3%). In the univariate analysis, the percentage of patients with SHS increased with the levels of triglyceride, fasting plasma glucose, HbA1c and BMI. SHS was observed less frequently among those who had been treated with oral tenofovir for 2 years or longer. Neither Hepatitis B surface Antigen (HBsAg) -positive rates, the duration for which patients were positive for HBsAg, HCV antibody-positive rates, nor the duration for which patients were positive for HCV RNA were associated with SHS. In a multivariate analysis, the only factor associated with SHS was BMI (adjusted odds ratio 1.727, 95% CI: 1.095 2.724; P = 0.019). Conclusion: The prevalence of SHS was markedly higher as 42.3% among HIV-infected patients and higher BMI in Japanese individuals was associated with SHS. *Corresponding author: Noboru Hirashima, MD/Ph.D, Department of Gastroenterology, National Hospital Organization, Nagoya Medical Center, Sannomaru, Naka, Nagoya 460-0001, Japan. Tel: +81-52-951-1111; Fax: +81-52-951-0664; E-mail: [email protected] Received Date: November 5, 2015 Accepted Date: November 30, 2015 Published Date: December 2, 2015 Citation: Hirashima, N., et al. Hepatic Steatosis, Measured by Transient Elastography with Controlled Attenuation Parameter, Is Highly Prevalent in Japanese HIV-Infected Patients. (2015) J Gastrointest Disord Liver Func 1(2): 2531. J Gastrointest Disord Liver Func | volume 1: issue 2 Introduction Hepatic steatosis (HS) is one of the most common causes of liver disease in human immunodeficiency virus (HIV)-infected patients as well as in the general population[1,2]. HS is associated with an increased risk of liver inflammation and fibrosis, “so called” Nonalcoholic Steatohepatitis (NASH), a recognized cause of Liver Cirrhosis (LC) and Hepatocellular Carcinoma (HCC). HS in HIV-infected patients may progress to NASH, LC and HCC. The prevalence of HS and its risk factors in HIV-infected patients currently remain unclear[3]. HS rates in HIV-infected patients have been estimated based on the findings of previously conducted liver biopsy studies, which mostly involved HIV/HCV-co-infected patients. Liver biopsy is an invasive technique and sampling errors are common[4-6]. A new non-invasive assessment of HS through the measurement of controlled attenuation parameter (CAP) using the Copyrights: © 2015 Hirashima, N. This is an Open access article distributed under the terms of Creative Commons Attribution 4.0 International License. 25 1Department of Gastroenterology, National Hospital Organization Nagoya Medical Center, Nagoya, Japan 2Department of Infectious Diseases and Immunology, Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan 3Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan 4Department of Clinical Trials and Research, National Hospital Organization Nagoya Medical Center, Nagoya, Japan