HEPATIC STEATOSIS, MEASURED BY TRANSIENT ELASTOGRAPHY WITH CONTROLLED ATTENUATION PARAMETER, IS HIGHLY PREVALENT IN JAPANESE HIV-INFECTED PATIENTS

Objective: HIV-infected patients are at an increased risk of developing hepatic steatosis (HS), which may progress to nonalcoholic steatohepatitis. The aim of this study was to evaluate HS in Japanese HIV-infected patients using a novel technique called controlled attenuation parameter (CAP). Methods: Sixty HIV-infected outpatients were included in this study and underwent transient elastography with CAP. Significant hepatic steatosis (SHS) was defined using the previously established CAP cut-off of 232 dB/m. The relationships between SHS and blood chemistry, HBV / HCV co-infection, and antiretroviral drugs were analyzed in HIV-infected patients. Results: The mean CAP level was 228 dB/m. SHS was detected in 25 patients (42.3%). In the univariate analysis, the percentage of patients with SHS increased with the levels of triglyceride, fasting plasma glucose, HbA1c and BMI. SHS was observed less frequently among those who had been treated with oral tenofovir for 2 years or longer. Neither Hepatitis B surface antigen (HBsAg)-positive rates, the duration for which patients were positive for HBsAg, HCV antibody-positive rates, nor the duration for which patients were positive for HCV RNA were associated with SHS. In a multivariate analysis, the only factor associated with SHS was BMI (adjusted odds ratio 1.727, 95%CI: 1.095-2.724; P=0.019). Conclusion: The prevalence of SHS was markedly higher as 42.3% among HIV-infected patients, and higher BMI in Japanese individuals was associated with SHS.