| Autor: |
Busca Arenzana C; HIV Unit. Department of Internal Medicine, La Paz University Hospital, 28046 Madrid, Spain., Quintana Castanedo L; Department of Dermatology, La Paz University Hospital, 28046 Madrid, Spain., Chiloeches Fernández C; Department of Dermatology, La Paz University Hospital, 28046 Madrid, Spain., Nieto Rodríguez D; Department of Dermatology, La Paz University Hospital, 28046 Madrid, Spain., Herranz Pinto P; Department of Dermatology, La Paz University Hospital, 28046 Madrid, Spain., Delgado Hierro AB; HIV Unit. Department of Internal Medicine, La Paz University Hospital, 28046 Madrid, Spain., Olveira Martín A; Hepatology Unit, Department of Gastroenterology, La Paz University Hospital, 28046 Madrid, Spain., Montes Ramírez ML; HIV Unit. Department of Internal Medicine, La Paz University Hospital, 28046 Madrid, Spain. |
| Abstrakt: |
Background/objectives : Psoriasis is the most frequent skin disease in HIV-infected patients. Nonalcohol fatty liver disease (NAFLD) is more prevalent in patients with psoriasis. We report the prevalence of psoriasis and NAFLD and investigate risk factors of liver damage in HIV-infected patients with psoriasis. Methods : We performed a retrospective observational study. Steatosis was defined as indicative abdominal ultrasound findings, CAP (controlled attenuated parameter by transient elastography) > 238 dB/m, and/or triglyceride and glucose index (TyG) > 8.38. Significant (fibrosis ≥ 2) and advanced liver fibrosis (fibrosis ≤ F3) were studied by transient elastography (TE) and/or FIB-4 using standard cutoff points. FIB-4 (Fibrosis 4 score) results were adjusted for hepatitis C (HCV)-coinfected patients. Results : We identified 80 patients with psoriasis (prevalence, 1.5%; 95% CI, 1.1-1.8). Psoriasis was severe (PASI > 10 and/or psoriatic arthritis) in 27.5% of cases. The prevalence of steatosis was 72.5% (95% CI, 65-85). Severe psoriasis was an independent risk factor for steatosis (OR, 12; 95% CI, 1.2-120; p = 0.03). Significant liver fibrosis ( p < 0.05) was associated with HCV coinfection (OR 3.4; 95% CI, 1.1-10.6), total CD4 (OR 0.99; 95% CI, 0.99-1), and time of efavirenz exposure (OR 1.2; 95% CI, 1.0-1.3). Conclusions : The prevalence of psoriasis in HIV-infected patients was similar to that of the general population. Steatosis is highly prevalent, and severe psoriasis is an independent risk factor for steatosis in HIV-infected patients. |
