Non-Alcoholic Fatty Liver Disease and Its Sarco-Metabolic Correlates in People Living with Human Immunodeficiency...

Non-alcoholic fatty liver disease (NAFLD) and sarcopenia are increasingly identified in People Living with Human Immunodeficiency Virus (HIV) (PLHIV), contributing to cardiometabolic risk. This study aims to assess the prevalence and sarcometabolic associations of NAFLD in PLHIV.

The study included 60 clinically stable patients on anti-retroviral treatment (>1 year). Patients with liver diseases, Hepatitis B/C, and significant alcohol intake were excluded. Hepatic inflammation was assessed via FibroScan-AST score (FAST), steatosis via Controlled Attenuation Parameter obtained from Fibroscan, and fibrosis using APRI, FIB-4, and Liver Stiffness Measurement. Sarcopenia was assessed using hand grip strength measured using a hydraulic dynamometer and skeletal muscle mass via Dual-Energy X-ray Absorptiometry. Sarcometabolic parameters were compared between PLHIV with and without NAFLD.

The study enrolled 60 patients (mean age: 37.12 ± 9.26 years; 46 (76.67%) males). The NAFLD frequency was 20%, with the majority having grade 3 steatosis. Hepatic inflammation (FAST score) was higher in NAFLD group (0.34 vs 0.12, P = 0.001). Obesity (body mass index) was significantly higher in NAFLD (66.67% vs 18.75%), P = 0.002}. The sarcopenia prevalence was 10%, with pre-sarcopenia (low muscle mass) of 45%. The muscle strength and mass were higher in NAFLD patients but not statistically significant. High triglycerides was a significant NAFLD risk factor {adjusted OR: 5.75 (1.11-29.73)}.

NAFLD prevalence in stable Indian PLHIV is significant considering a high cardiovascular disease risk in this population. Hypertriglyceridemia seems to be significantly associated as a risk factor. Return to health and nutrition have positively impacted muscle health with a downside of developing fatty liver.