Background Liver disease has become an important cause of morbidity and mortality
even in those HIV-infected individuals who are devoid of hepatitis virus co-infection.
The aim of this study was to evaluate the degree of hepatic fibrosis and the role
of associated factors using liver stiffness measurement in HIV mono-infected patients
without significant alcohol intake. Methods We performed a cross-sectional study of
101 HIV mono-infected patients recruited prospectively from March 1, 2014 to October
30, 2014 at the Center for HIV, St István and St László Hospital, Budapest, Hungary.
To determine hepatic fibrosis, liver stiffness was measured with transient elastography.
Demographic, immunologic and other clinical parameters were collected to establish
a multivariate model. Bayesian Model Averaging (BMA) was performed to identify predictors
of liver stiffness. Results Liver stiffness ranged from 3.0–34.3 kPa, with a median
value of 5.1 kPa (IQR 1.7). BMA provided a very high support for age (Posterior Effect
Probability-PEP: 84.5%), moderate for BMI (PEP: 49.3%), CD4/8 ratio (PEP: 44.2%) and
lipodystrophy (PEP: 44.0%). For all remaining variables, the model rather provides
evidence against their effect. These results overall suggest that age and BMI have
a positive association with LS, while CD4/8 ratio and lipodystrophy are negatively
associated. Discussion Our findings shed light on the possible importance of ageing,
overweight and HIV-induced immune dysregulation in the development of liver fibrosis
in the HIV-infected population. Nonetheless, further controlled studies are warranted
to clarify causal relations.
