Infectious Disease · Gastroenterology · 3 h ago
HIV and Steatosis Predict Liver Fibrosis in Women, With Different Associations by HIV Status
In a cohort of 1,036 women followed for a mean of 3.5 years, investigators assessed predictors of new liver fibrosis using serial transient elastography. HIV was associated with higher fibrosis incidence, while the association with liver fat was weaker among women with HIV.
- 19% developed fibrosis over a mean 3.5 years.
- HIV was associated with higher incident fibrosis.
- CAP’s association with fibrosis was weaker in women with HIV.
- Fibrosis without steatosis was common among women with HIV.
This longitudinal cohort study included 1,036 women in the Women’s Interagency HIV Study (709 with HIV and 327 without HIV) who had at least two vibration-controlled transient elastography examinations between 2013 and 2020. Participants with viral hepatitis, heavy alcohol use, or fibrosis at baseline were excluded. Incident fibrosis was defined as liver stiffness of at least 7.1 kPa; models included time-updated covariates and examined liver steatosis measured by controlled attenuation parameter (CAP).
Over a mean 3.5 years of follow-up, 19% developed incident fibrosis. HIV was associated with higher incidence (adjusted incidence rate ratio [IRR] 1.72, 95% CI 1.12–2.65). Each 10 dB/m higher CAP was associated with a small increase in incidence overall (IRR 1.04, 95% CI 1.00–1.08), but this association differed by HIV status and was attenuated among women with HIV (interaction p=0.02). Among women with HIV, 28% of new fibrosis occurred without steatosis; this was more common in those with prior AIDS.
The findings identify HIV status and steatosis as differently associated with fibrosis risk in this selected cohort. The observational design and elastography-based outcome do not establish mechanisms or demonstrate that changing clinical monitoring or management improves outcomes.
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The Journal of Infectious Diseases: Predictors of Incident Hepatic Fibrosis and Steatotic Liver Disease–Associated Fibrosis Among Women with and without HIV ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.