Among patients with well controlled HIV and low to moderate cardiovascular risk, hepatic steatosis and non alcoholic fatty liver disease (NAFLD) were common and tied to metabolic and inflammatory disruptions, but not factors related to HIV or ART, according to findings published in AIDS. Carl J. Fichtenbaum, MD, and colleagues examined 687 patients with HIV who underwent non-contrast CT. They reported a hepatic steatosis prevalence of 22% and a NAFLD prevalence of 21%. Factors associated with higher steatosis/NAFLD prevalence included male sex, older age, non-Black race, and higher BMI and waist circumference. Both steatosis and NAFLD were associated with a BMI of 30 and higher, components of metabolic syndrome, and lower HDL cholesterol, among other factors. History of an AIDS-defining illness was the only characteristic related to HIV/ART that was more common among patients with steatosis/NAFLD. Following adjustments for age, sex, and race/ ethnicity, Dr. Fichtenbaum and colleagues found that a BMI greater than 30, a homeostatic model assessment of insulin resistance of greater than two, and metabolic syndrome and its components were associated with NAFLD prevalence
