Duration of HAART use: A key prognosticator for NAFLD in HAART experienced HIV patients

Background: The Human immunodeficiency disease (HIV) remains a global menace decades after its discovery and despite advances in therapeutics and use of Highly active antiviral therapies (HAART). HIV/AIDS patients now have longer lifespan with increased non-AIDS related morbidity and mortality. Non-alcoholic fatty liver diseases (NAFLD), a global public health challenge has been identified as one of the leading causes of morbidity and mortality in HIV infected persons. Our study aimed to identify the risk factors for NAFLD in HIV infected patients and to relate the liver enzymes derangement to NAFLD.

Method: we retrospectively analyzed data from 170 HAART experienced viral hepatitis sero-negative HIV patients. Sociodemographic, anthropometric, and laboratory characteristics were extracted. Hepatic steatosis was diagnosed by ultrasound scan.

Result: NAFLD was present in 27.9% of the patients and the duration of HAART use (p<0.001), elevated plasma glucose level (p<0.001), increased waist circumference (p=0.004), duration of HIV infection (p=0.026), and elevated serum triglycerides (p=0.033) were identified as the major risk factors for NAFLD. Using the Wald test of variables, duration of HAART use was identified as the key prognosticator of NAFLD in HIV patient [Wald value (WV) of 10.749 (p= 0.001)].

Reduced CD4 cell count and liver enzyme derangement were not identified as risk factors for NAFLD.

Conclusion: NAFLD is common in HAART experienced HIV patients and the duration of HAART use is the most important predictor for its occurrence. Early recognition and vigorous modification of these risk factors among HIV patients are necessary to prevent further progression of NAFLD.