Predictors of chronic liver disease in individuals with human immunodeficiency virus infection

Ann Hepatol. 2013;13(1):60-4.

Abstract

INTRODUCTION. Chronic liver disease (CLD) is becoming a major cause of mortality in patients who are positive with human immunodeficiency virus (HIV). Our aim was to assess the prevalence of CLD in HIV+ individuals. MATERIAL AND METHODS. We utilized the National Health and Nutrition Examination Survey (1999-2008) to assess the association of CLD with HIV infection. In eligible participants (18-49 years), HIV infection was defined as positive anti-HIV by enzyme immunoassay further confirmed by Western blot. The diagnosis of CLD included chronic hepatitis C (CH-C), alcohol-related liver disease (ALD) and non-alcoholic fatty liver disease (NAFLD). Clinic-demographic and laboratory parameters were used to assess differences between those with and without HIV infection. RESULTS. 14,685 adults were included. Of those, 0.43 ± 0.08% were HIV-positive and 13.8% had evidence of CLD, including 26.3% in HIV-positive individuals and 13.7% in HIV-negative controls (p = 0.0341). In the U.S. population, independent predictors of CLD included HIV positivity [OR = 1.96 (1.02-3.77), p = 0.04], older age [OR = 1.03 (1.02-1.03), p < 0.0001], male gender [OR = 2.15 (1.89-2.44), p < 0.0001] and obesity [OR = 2.10 (1.82-2.43), p < 0.0001], while African American race/ethnicity was associated with lower risk for CLD [OR = 0.68 (0.58-0.80), p < 0.0001]. CONCLUSIONS. CLD is common in HIV positive individuals. With successful long term treatment of HIV, management of CLD will continue to remain very important in these patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Black or African American / statistics & numerical data
  • Coinfection
  • Fatty Liver / epidemiology*
  • Fatty Liver / ethnology
  • Female
  • HIV Infections / epidemiology*
  • HIV Infections / ethnology
  • Hepatitis C, Chronic / epidemiology*
  • Hepatitis C, Chronic / ethnology
  • Hispanic or Latino / statistics & numerical data
  • Humans
  • Liver Diseases, Alcoholic / epidemiology*
  • Liver Diseases, Alcoholic / ethnology
  • Logistic Models
  • Male
  • Middle Aged
  • Non-alcoholic Fatty Liver Disease
  • Nutrition Surveys
  • Prevalence
  • Risk Factors
  • United States / epidemiology
  • White People / statistics & numerical data
  • Young Adult