Human Immunodeficiency Virus Is the Major Determinant of Steatosis and Hepatitis C Virus of Insulin Resistance in Virus-associated Fatty Liver Disease
| Autor: | Federica Carli, Giovanni Guaraldi, Stefano Ballestri, Lucia Carulli, Chiara Stentarelli, Paola Loria, Alberto Roverato, Gabriella Orlando, Stefano Zona, Amedeo Lonardo |
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| Přispěvatelé: | G. Guaraldi, A. Lonardo, S. Ballestri, S. Zona, C. Stentarelli, G. Orlando, F. Carli, L. Carulli, A. Roverato, P. Loria |
| Rok vydání: | 2011 |
| Předmět: |
Adult
Male Hepatitis C virus HIV Infections Hepacivirus medicine.disease_cause Insulin resistance non-alcholic fatty liver Non-alcoholic Fatty Liver Disease insulin resistance Fatty liver Nonalcoholic fatty liver disease Prevalence Humans Medicine Co-infection Human immunodeficiency virus Coinfection business.industry fibrosis NASH HIV virus diseases General Medicine Odds ratio Middle Aged Viral Load medicine.disease Hepatitis C digestive system diseases HCV viral load Logistic Models Multivariate Analysis Immunology Linear Models Female Insulin Resistance Steatosis Metabolic syndrome business Viral load |
| Zdroj: | Archives of Medical Research. 42:690-697 |
| ISSN: | 0188-4409 |
| DOI: | 10.1016/j.arcmed.2011.12.009 |
| Popis: | Background and Aims To promote our understanding of the relative contribution of metabolic and viral factors, the independent predictors of fatty liver and insulin resistance (IR) were assessed by comparing patients with nonalcoholic fatty liver disease (NAFLD) to individuals with virus-associated fatty liver disease (VAFLD): human immunodeficiency virus (HIV)-VAFLD, hepatitis C virus (HCV)-VAFLD and HIV-HCV-VAFLD. Methods One hundred eighty eight consecutive patients with viral infections (103 HIV, 85 patients with HCV genotype 1 infection: 45 mono-infected and 40 HIV/HCV co-infected) with or without steatosis and 126 NAFLD patients were analyzed. Steatosis was diagnosed by ultrasonography. To assess the odds ratio (OR) of steatosis and IR, HCV and NAFLD, respectively, were used as the reference values. IR was evaluated through homeostasis model (HOMA) and the metabolic syndrome (MetS) using standard criteria. Results The prevalence of VAFLD was 47%. Multivariate logistic regression analysis was carried out using HCV as the reference. VAFLD was predicted by HIV, HIV/HCV, female gender, waist circumference (WC) and HOMA (OR = 3.99, 3.76, 2.80, 1.08 and 1.18). According to multiple linear regression using NAFLD as the reference, IR was predicted by HCV, HIV and HIV/HCV, WC, triglycerides (coefficient beta = 2.25, 0.99, 1.86, 0.08, 0.05, respectively). In linear models, for any given number of components of MetS, HCV and HCV/HIV-associated fatty liver disease had greater HOMA compared to NAFLD (p Conclusions Whereas HIV confers a higher risk of steatosis, VAFLD is associated with higher IR than NAFLD and such an effect is specifically linked to HCV rather than to HIV infection. |
| Databáze: | OpenAIRE |
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