ArticleBMJ open2022
Multisite prospective Liver Disease and Reproductive Ageing (LIVRA) study in US women living with and without HIV.
Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
11 citing papers in PubMed, 11 citations in OpenAlex.
- Higher plasma kynurenine-tryptophan ratio predicts incident hepatic fibrosis in women with HIV.AIDS (London, England) · 2026Article
- UltRaSoUnd-guided evaLuAtion of metabolic health in a cohort of midlife women with HIV: The URSULA study.HIV medicine · 2026Article
- PREVALENCE AND SEVERITY OF STEATOTIC LIVER DISEASE IN WOMEN WITH AND WITHOUT HIV.Journal of acquired immune deficiency syndromes (1999) · 2026Article
- Synergistic Impact of Obesity and PCOS on Immune Dysregulation: A Review of Systemic and Local Inflammatory Profiles.International journal of women's health · 2026Review
- The association of food insecurity with hepatic steatosis in women with and without HIV.AIDS (London, England) · 2025Article
- Female Sex is Protective Against MASLD With Clinically Significant Fibrosis in a Large Cross-sectional Cohort of Persons With HIV.Open forum infectious diseases · 2025Article
- Noninvasive Markers of Hepatic Steatosis and Fibrosis Following Integrase Strand-Transfer Inhibitor Initiation in Women With HIV.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Article
- Microbial translocation and gut damage is associated with hepatic fibrosis but not steatosis in women with and without HIV.AIDS (London, England) · 2025Article
- Optimizing cardiometabolic risk in people living with human immunodeficiency virus: A deep dive into an important risk enhancer.American journal of preventive cardiology · 2024Review
- Microbial Translocation and Gut Damage Are Associated With an Elevated Fast Score in Women Living With and Without HIV.Open forum infectious diseases · 2024Article
- Fatty Liver Disease: Enter the Metabolic Era.Current HIV/AIDS reports · 2023Review
Corrections and comments
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Authors and funding
12 authors at 11 institutions in 1 country.
Funding
Abstract
purposeThe Liver Disease and Reproductive Ageing (LIVRA) study leverages the infrastructure of the decades-long multicentre prospective Women's Interagency HIV Study (WIHS) to examine the contributions of HIV, hepatitis C virus (HCV) and ageing to liver disease progression in women.
participantsFrom 2013 to 2018, LIVRA enrolled 1576 participants (77 HCV-seropositive only, 248 HIV/HCV-seropositive, 868 HIV-seropositive only and 383 HIV/HCV-seronegative) who underwent vibration controlled transient elastography (VCTE). A VCTE quality assurance programme was established to ensure consistency and accuracy for longitudinal assessment of steatosis (fatty liver) via the controlled attenuation parameter (CAP) and fibrosis via liver stiffness (LS). Demographic, lifestyle factors, anthropometry, clinical and medication history, host genetics, immune markers and hormone levels were collected as part of the WIHS. FINDINGS TO DATE: At baseline, 737 of 1543 women with CAP measurements had steatosis (CAP ≥248 dB/m) and 375 of 1576 women with LS measurements had significant fibrosis (LS ≥7.1 kPa), yielding a prevalence of 48% and 24%, respectively. On multivariable analysis, waist circumference (WC) and insulin resistance were independently associated with higher CAP (17.8 dB/m per 10 cm (95% CI:16.2 to 19.5) and 1.2 dB/m per doubling (95% CI:0.8 to 1.6), respectively). By contrast, HIV/HCV seropositivity and HCV seropositivity alone were associated with less steatosis compared with HIV/HCV-seronegative women, although the latter did not reach statistical significance (-9.2 dB/m (95% CI:-18.2 to -0.3) and -10.4 dB/m (95% CI: -23.8 to 3.1), respectively). Factors independently associated with higher LS were age (4.4% per 10 years (95% CI: 0.4% to 8.4%)), WC (5.0% per 10 cm (95% CI: 3.3% to 6.6%)), CAP steatosis (0.6% per 10 dB/m (95% CI: 0.1% to 1.0%)), HIV/HCV seropositivity (33% (95% CI: 24% to 44%)) and HCV seropositivity alone (43% (95% CI: 28% to 60%)). Excluding scans that were invalid based on traditional criteria for unreliability did not affect the results. FUTURE PLANS: Enrolled women undergo VCTE at 3-year intervals unless LS is ≥9.5 kPa, indicating advanced fibrosis, in which case VCTE is performed annually. Participants also undergo VCTE every 6 months until 18 months after HCV treatment initiation. Analysis of the data collected will provide insights into the impact of ageing/ovarian function, host genetics, immune function and contemporary HIV and HCV treatments on liver disease progression.
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