ArticleJournal of the International AIDS Society2024
Metabolic causes of liver disease among adults living with HIV from low- and middle-income countries: a cross-sectional study.
Article in Journal of the International AIDS Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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9 citing papers in PubMed, 13 citations in OpenAlex.
- Predictors of Liver Steatosis Progression Among People Living With HIV in Low- and Middle-Income Countries: A Multicentre Longitudinal Study.Journal of the International AIDS Society · 2026Article
- Food insecurity and cardiometabolic diseases among people with HIV in West Africa.AIDS (London, England) · 2026Article
- Diagnostic value of serological scores for the detection of liver steatosis in people with HIV in low- and middle-income countries.AIDS (London, England) · 2026Article
- Metabolic dysfunction-associated liver disease predicts incident liver fibrosis in people with HIV mono-infection: A cohort study.HIV medicine · 2025Observational
- Trends and disparities in human immunodeficiency virus and chronic liver disease mortality in the United States: A nationwide analysis.The Journal of international medical research · 2025Article
- Food insecurity and mental health outcomes among people with HIV in West Africa.AIDS (London, England) · 2025Article
- Integrated Behavioral and Biological Surveillance Among People Living With HIV Visiting the Antiretroviral Therapy Centers in India: Protocol for a Cross-Sectional Surveillance.JMIR research protocols · 2025Article
- Comorbidities and HIV-related factors associated with mental health symptoms and unhealthy substance use among older adults living with HIV in low- and middle-income countries: a cross-sectional study.Journal of the International AIDS Society · 2025Article
- Perceptions and management of diabetes and obesity among people living with HIV in Côte d'Ivoire: a qualitative study.BMC public health · 2025Article
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23 authors at 14 institutions in 12 countries.
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Abstract
introductionLiver disease is a leading cause of morbidity and mortality among persons living with HIV (PLHIV). While chronic viral hepatitis has been extensively studied in low- and middle-income countries (LMICs), there is limited information about the burden of metabolic disorders on liver disease in PLHIV.
methodsWe conducted a cross-sectional analysis of baseline data collected between October 2020 and July 2022 from the IeDEA-Sentinel Research Network, a prospective cohort enrolling PLHIV ≥40 years on antiretroviral treatment (ART) for ≥6 months from eight clinics in Asia, Americas, and central, East, southern and West Africa. Clinical assessments, laboratory testing on fasting blood samples and liver stiffness measurement (LSM)/controlled attenuation parameter (CAP) by vibration-controlled transient elastography were performed. Multivariable logistic regression models assessed factors associated with liver fibrosis (LSM ≥7.1 kPa) and steatosis (CAP ≥248 dB/m). Population attributable fraction (PAF) of each variable associated with significant liver fibrosis was estimated using Levin's formula.
resultsOverall, 2120 PLHIV (56% female, median age 50 [interquartile range: 45-56] years) were included. The prevalence of obesity was 19%, 12% had type 2 diabetes mellitus (T2DM), 29% had hypertension and 53% had dyslipidaemia. The overall prevalence of liver fibrosis and steatosis was 7.6% (95% confidence interval [CI] 6.1-8.4) and 28.4% (95% CI 26.5-30.7), respectively, with regional variability. Male sex at birth (odds ratio [OR] 1.62, CI 1.10-2.40), overweight/obesity (OR = 2.50, 95% CI 1.69-3.75), T2DM (OR 2.26, 95% CI 1.46-3.47) and prolonged exposure to didanosine (OR 3.13, 95% CI 1.46-6.49) were associated with liver fibrosis. Overweight/obesity and T2DM accounted for 42% and 11% of the PAF for liver fibrosis, while HBsAg and anti-HCV accounted for 3% and 1%, respectively. Factors associated with steatosis included overweight/obesity (OR 4.25, 95% CI 3.29-5.51), T2DM (OR 2.06, 95% CI 1.47-2.88), prolonged exposure to stavudine (OR 1.69, 95% CI 1.27-2.26) and dyslipidaemia (OR 1.68, 95% CI 1.31-2.16).
conclusionsMetabolic disorders were significant risk factors for liver disease among PLHIV in LMICs. Early recognition of metabolic disorders risk factors might be helpful to guide clinical and lifestyle interventions. Further prospective studies are needed to determine the causative natures of these findings.
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