Prevalence and predictors of hepatic steatosis among HIV patients with and without chronic hepatitis C

Hepatic steatosis (HS) is a common and important histologic finding in patients with chronic hepatitis C virus (HCV) infection. However, little is known about this finding in HCV patients co-infected with human immunodeficiency virus (HIV).

To evaluate the prevalence and predictors of HS among HIV patients with and without HCV.

A cross-sectional including 47 HIV mono-infected and 50 HIV/HCV patients. Detailed demographic, laboratory and clinical data were collected. A transient elastography (TE) examination with the controlled attenuation parameter (CAP) was performed for all patients. Steatosis was scored on a scale from 0 to 3 according to the percentage of steatosis involving hepatocytes.

HS was detected in 18 /50 (36%) HIV/HCV co-infected patients and 22 /47 (46.8%) HIV mono-infected patients. In addition, HCV mono-infected patients were more likely to have grade 2 steatosis as compared with HIV/HCV co-infected individuals (25.5% vs. 12%). LSM was significantly higher among HIV/HCV co-infected patients (p = 0.003). When dividing HIV/HCV co-infected and HIV mono-infected group according to CAP values. BMI, abdominal wall thickness, and bright liver were significantly associated with SHS (CAP ≥ 238 dB/m) in both groups. Diabetes was only significantly associated with SHS in HIV/HCV co-infected group BMI was the only independent predictor of SHS among the whole group and subgroup analysis.

The prevalence of HS was lower in HIV/HCV co-infected patients compared to HIV mono-infected patients; we cannot say that HCV has a protective role against HS in co-infected patients. More fibrosis progression was common in the HIV/HCV co-infected patients.