BACKGROUND People living with HIV (PWH) may be at risk of non-alcoholic fatty liver disease (NAFLD). We compared the prevalence of moderate-to-severe hepatic steatosis (M-HS) in PWH with HIV-uninfected controls and determined risk factors for M-HS in PWH. METHODS The Copenhagen Co-Morbidity in HIV infection Study included 453 participants and the Copenhagen General Population Study 765 participants. None had prior or current viral hepatitis or excessive alcohol intake. M-HS was assessed by unenhanced CT liver scan defined by liver attenuation ≤48 Hounsfield units. Adjusted odds ratios (aOR) were computed by adjusted logistic regression. RESULTS The prevalence of M-HS was lower in PWH compared to uninfected controls (8.6% vs. 14.2%, p<0.01). In multivariable analyses, HIV (aOR:0.44, p<0.01); female sex (aOR:0.08, p=0.03); physical activity level (aOR 0.09 very active vs inactive, p<0.01); and alcohol (aOR:0.89 per unit/week, p=0.02) was protective factors, while BMI (aOR:1.58 per 1 kg/m2, p<0.01); ALT (aOR:1.76 per 10 U/L, p<0.01); and exposure to integrase inhibitors (aOR: 1.28 per year, p=0.02) were associated with higher odds of M-HS. CONCLUSIONS Moderate-to-severe hepatic steatosis is less common in PWH compared to demographically comparable uninfected controls. Besides BMI and ALT, integrase inhibitor exposure was associated with higher prevalence of steatosis in PWH.

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人类免疫缺陷病毒感染中至重度肝脂肪变性的患病率和危险因素：哥本哈根共病肝研究。

背景技术HIV感染者（PWH）可能有非酒精性脂肪肝疾病（NAFLD）的风险。我们比较了PWH中中重度肝脂肪变性（M-HS）与未感染HIV的对照的患病率，并确定了PWH中M-HS的危险因素。方法哥本哈根HIV感染合并症研究共453名参与者，哥本哈根普通人群研究共765名参与者。没有人曾经或现在患有病毒性肝炎或过量饮酒。M-HS通过未增强的CT肝脏扫描评估，其定义为肝脏衰减≤48 Hounsfield单位。通过调整后的逻辑回归来计算调整后的优势比（aOR）。结果与未感染的对照组相比，PWH中M-HS的患病率较低（8.6％比14.2％，p <0.01）。在多变量分析中，HIV（aOR：0.44，p <0.01）；女性（aOR：0.08，p = 0.03）; 身体活动水平（活跃或不活跃的aOR 0.09，p <0.01）；酒精（aOR：每单位/周0.89，p = 0.02）是保护因子，而BMI（aOR：每1 kg / m2 1.58，p <0.01）；ALT（aOR：每10 U / L 1.76，p <0.01）；暴露于整合酶抑制剂（aOR：每年1.28，p = 0.02）与M-HS发生几率较高相关。结论与人口统计学上未感染的对照相比，PWH中轻度至重度肝脂肪变性较不常见。除BMI和ALT外，整合酶抑制剂的暴露与PWH中脂肪变性的患病率更高有关。02）与M-HS的较高机率相关。结论与人口学上可比较的未感染对照相比，PWH中中度至重度肝脂肪变性较不常见。除BMI和ALT外，整合酶抑制剂的暴露与PWH中脂肪变性的患病率更高有关。02）与M-HS的较高机率相关。结论与人口统计学上未感染的对照相比，PWH中轻度至重度肝脂肪变性较不常见。除BMI和ALT外，整合酶抑制剂的暴露与PWH中脂肪变性的患病率更高有关。