Natural Course of Nonalcoholic Fatty Liver Disease and Type 2 Diabetes in Patients With Human Immunodeficiency Virus With and Without Combination Antiretroviral Therapy-associated Lipodystrophy : A 16-Year Follow-up Study

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Lallukka-Brück , S , Isokuortti , E , Luukkonen , P K , Hakkarainen , A , Lundbom , N , Sutinen , J & Yki-Järvinen , H 2020 , ' Natural Course of Nonalcoholic Fatty Liver Disease and Type 2 Diabetes in Patients With Human Immunodeficiency Virus With and Without Combination Antiretroviral Therapy-associated Lipodystrophy : A 16-Year Follow-up Study ' , Clinical Infectious Diseases , vol. 70 , no. 8 , pp. 1708-1716 . https://doi.org/10.1093/cid/ciz435

Title: Natural Course of Nonalcoholic Fatty Liver Disease and Type 2 Diabetes in Patients With Human Immunodeficiency Virus With and Without Combination Antiretroviral Therapy-associated Lipodystrophy : A 16-Year Follow-up Study
Author: Lallukka-Brück, Susanna; Isokuortti, Elina; Luukkonen, Panu K.; Hakkarainen, Antti; Lundbom, Nina; Sutinen, Jussi; Yki-Järvinen, Hannele
Contributor: University of Helsinki, HUS Internal Medicine and Rehabilitation
University of Helsinki, HUS Internal Medicine and Rehabilitation
University of Helsinki, HUS Internal Medicine and Rehabilitation
University of Helsinki, HUS Medical Imaging Center
University of Helsinki, HUS Medical Imaging Center
University of Helsinki, HUS Inflammation Center
University of Helsinki, Department of Medicine
Date: 2020-04-15
Language: eng
Number of pages: 9
Belongs to series: Clinical Infectious Diseases
ISSN: 1058-4838
URI: http://hdl.handle.net/10138/329529
Abstract: Background: Abnormal glucose metabolism and nonalcoholic fatty liver disease (NAFLD) are common in patients with human immunodeficiency virus (HIV+ patients), but longitudinal data are lacking. We determined the natural course of NAFLD (liver fat [LFAT]) and type 2 diabetes mellitus (T2DM) in HIV+ patients with and without lipodystrophy (LD+ and LD-, respectively) during a 16-year longitudinal study. Methods: LFAT (by proton magnetic resonance spectroscopy) and clinical characteristics were measured in 41 HIV+ patients at baseline and after 16 years. Liver fibrosis was estimated by measuring liver stiffness using transient elastography (TE) and magnetic resonance elastography (MRE) at 16 years. We also longitudinally studied 28 healthy subjects. Results: During follow-up, the HIV+ patients gained more body fat (8.6% 0.7%) than the control patients (4.5% 0.6%, P <.001). Features of insulin resistance increased significantly in the HIV+ patients but not the control patients. A significant proportion (20%, P <.01 vs 0% at baseline) of the HIV+ but none of the control patients developed T2DM. LFAT was significantly higher at baseline in the LD+ (4.3 [1.9-11.8]) than the LD- (1.0 [0.5-1.5]; P <.001) HIV+ patients. LFAT remained stable during follow-up in all groups. At follow-up, liver stiffness measured with TE was similar among all HIV, LD+, LD-, and control patients and between the LD+ and LD- patients measured with MRE. Advanced fibrosis by MRE was observed in 3 of LD+ and none of LD- patients. Conclusions: During 16 years of follow-up, progression of NAFLD is rare compared to development of T2DM in HIV+ patients.
Subject: human immunodeficiency virus
nonalcoholic fatty liver disease
glucose metabolism
magnetic resonance elastography
liver fibrosis
HIV-INFECTED PATIENTS
RISK-FACTORS
PREVALENCE
GLUCOSE
3121 General medicine, internal medicine and other clinical medicine
11832 Microbiology and virology
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