Factors Associated with Nonalcoholic Fatty Liver Disease in Patients Receiving Antiretroviral Therapy for HIV at a Hospital in Trujillo, Peru, 2023
Factores asociados a Esteatosis hepática no alcohólica en pacientes con tratamiento antirretroviral por VIH en un Hospital de Trujillo, Perú 2023
DOI:
https://doi.org/10.57188/ricsa.2026.002Keywords:
Type 2 Diabetes Mellitus (DM II); Obesity; HCV; HBV; HIV; Hepatic Steatosis; Gender. (Source: DeCS-BIREME)Abstract
Objective: analyze the risk factors associated with non-alcoholic fatty liver disease (NAFLD) in HIV patients during 2023. Material and Method: analytical, observational, cross-sectional, retrospective. The sample consisted of 141 patients diagnosed with HIV, treated at a hospital in Trujillo, among whom 42 cases of fatty liver disease were found. Factors such as obesity, DM II, disease treatment duration, coinfection with HBV and HCV, as well as a trend in gender, were observed. A chi-square test was performed, yielding a p-value of less than 0.005. A multivariate logistic regression analysis was used to adjust PR, using the SPSS program. Results: Highlighting a prevalence of 29.79%. It was identified that age, gender (higher risk in men), the duration of antiretroviral treatment, and coinfections with HBV and HCV (X2 = 297.4) (p-value = 0.001) (X2 = 249.6) (p-value = 0.001) have a significant relationship with the presence of NAFLD. Additionally, type II diabetes mellitus and obesity are key factors, suggesting the importance of an integrated management approach to reduce the impact of NAFLD in this population. Conclusions: They indicate that obesity and type II diabetes mellitus increase the risk of NAFLD in patients with HIV, while coinfection with HBV and, especially, with HCV also contributes to the development of this condition.
Downloads
References
1. Burgos-Santamarí´a D, Sa´nchez-Aldehuelo R, Figueroa-Tubí´o A, Mateos-Mun˜oz B. Enfermedad hepa´tica grasa no alcoho´lica. Medicine (Baltimore). 2020;13(4):173-181. doi: 10.1016/j.med.2020.02.001
2. Ospino Rodrí´guez M, Licona-Vera E, Raad Sarabia M, Betancur Va´squez C, Go´mez-A' lvarez L. Esteatohepatitis no alcoho´lica: de la fisiopatologí´a al diagno´stico. Arch Med (Manizales). 2022;18(8):1-4.
3. Saavedra Y, Mena V, Priken K. Efecto de la dieta mediterra´nea sobre indicadores histolo´gicos y pruebas de imagen en enfermedad de hí´gado graso no alcoho´lico. Gastroenterol Hepatol. 2022;45(5):350-360. doi: 10.1016/j.gastrohep.2021.06.006
4. Lazarus JV, Crespo J, Romero-Go´mez M, Agustí´n S, Barrera F, et al. Enfermedad del hí´gado graso no alcoho´lico: un estudio integral. Madrid: Libroacade´mico; 2021.
5. Rodrí´guez FA. I'ndice de masa corporal y esteatosis hepa´tica no alcoho´lica evaluada mediante imagenologí´a ultrasonogra´fica [tesis]. Lima: Universidad Nacional Mayor de San Marcos; 2016. Disponible en: https://core.ac.uk/reader/323347350
6. Arias Cruz J. Factores asociados a hí´gado graso no alcoho´lico en pacientes con VIH [tesis]. Trujillo: Universidad Ce´sar Vallejo; 2023. Disponible en: https://repositorio.ucv.edu.pe/bitstream/handle/20.500.12692/131838/Arias_CJY-SD.pdf
7. Calleja JL. Enfermedad de hí´gado graso no alcoho´lico: un estudio integral. Madrid: Libroacade´mico; 2021. Disponible en: https://aeeh.es/wpcontent/uploads/2022/02/EHGNA-pdf.pdf
8. Domí´nguez VM, Casas RG, Jime´nez-Ridruejo JM, Moreno-Otero R. Etiopatogenia, diagno´stico y tratamiento de la enfermedad del hí´gado graso no alcoho´lica. Rev Esp Enferm Dig. 2013;105(7):409-420. Disponible en: https://scielo.isciii.es/pdf/diges/v105n7/es_pun to_vista.pdf
9. Infante-Pina D, Pich-Rosal M. Hepatopatí´a aguda. An Sist Sanit Navar. 2020;14:1-12. Disponible en: https://www.aeped.es/sites/default/files/documentos/4-hepatopatia_aguda.pdf
10. Montan˜o-Loza AJ. Evaluacio´n de la fibrosis en pacientes con enfermedad de hí´gado graso no alcoho´lico. Rev Gastroenterol Mex. 2022;87(1):1-3. doi: 10.1016/j.rgmx.2021.04.004
11. Palacios-Baena ZR, Martí´n-Ortega M, Rí´os-Villegas MJ. Perfil de los nuevos diagno´sticos de infeccio´n por VIH y factores de riesgo asociados al diagno´stico tardí´o en una consulta especializada durante el periodo 2014-2018. Med Clin (Barc). 2020;155(11):482-487. doi: 10.1016/j.medcli.2020.01.035
12. Mora L, Mallolas J, Ambrosioni J. Epidemiologí´a, tratamiento y prono´stico de la infeccio´n VIH en 2024: revisio´n pra´ctica. Med Clin (Barc). 2024. doi: 10.1016/j.medcli.2023.12.007
13. Michel M, Labenz C, Wahl A, Anders M, Armandi A, Huber Y, et al. Prevalence and risk factors of nonalcoholic steatohepatitis with significant fibrosis in people with HIV. AIDS. 2022;36(12):1665-1674. doi:10.1097/QAD.0000000000003303
14. Abdulghani N, Gonza´lez E, Manzardo C, Casanova JM, Perica´s JM. Infeccio´n por el virus de la inmunodeficiencia humana (VIH). Sí´ndrome de inmunodeficiencia adquirida. FMC Form Med Contin Aten Primaria. 2020;27(3):63-74. doi: 10.1016/j.fmc.2020.03.008
15. Guille´n Martí´nez S. Prevalencia y factores de riesgo de hí´gado graso en pacientes con infeccio´n por VIH [tesis]. Murcia: Universidad de Murcia; 2021.
16. Guallipo Vargas M. Virus de inmunodeficiencia humana (VIH). Universidad Veracruzana. 2022;14(3):1-5. Disponible en: https://www.uv.mx/cendhiu/files/2016/08/VIH-apunte-de-Virologia-Medica-1.pdf
17. Martí´nez J, Lo´pez M. Relacio´n teo´rica entre obesidad, edad y diabetes en la enfermedad hepa´tica grasa no alcoho´lica. Rev Gastroenterol. 2022;34(2):123-130.
18. Corraliza ES, Martí´n AF. Efectos adversos de los fa´rmacos antirretrovirales: fisiopatologí´a, manifestaciones clí´nicas y tratamiento. An Med Interna (Madrid). 2006;23(7):338-344. Disponible en: https://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0212-71992006000700010
19. Cuzick J, Edwards R, Shankaranarayanan R, et al. Trends in the prevalence of non-alcoholic fatty liver disease in France: a nationwide study from 2000 to 2019. BMJ Open Gastroenterol. 2020;7(1):e000457. doi:10.1136/bmjgast-2020-000457
20. Jansen A, Alferink L, Van der Woude C, et al. Obesity, gender and age as risk factors for non-alcoholic fatty liver disease: findings from a German cohort study. J Hepatol. 2022;76(4):815-825. doi:10.1016/j.jhep.2021.11.027
21. Ferna´ndez Fuertes M. Impacto de la infeccio´n por el VIH en el desarrollo de la enfermedad hepa´tica grasa y ana´lisis de los condicionantes gene´ticos involucrados en la poblacio´n infectada [tesis]. Sevilla: Universidad de Sevilla; 2023. Disponible en: https://idus.us.es/handle/11441/143551
22. Ganesan M, Poluektova LY, Kharbanda KK, Osna NA. Human immunodeficiency virus and liver disease: challenges and opportunities. Ann Hepatol. 2021;20:100263. doi: 10.1016/j.aohep.2020.11.006
23. Gonza´lez-Merino M, Martí´nez-Jime´nez M, Ferna´ndez-Sa´nchez J, et al. Duration of HAART use as a key prognosticator of NAFLD in HAART-experienced HIV patients. GSC Adv Res Rev. 2022;12(1):16-23.
24. Ramí´rez N, Castro A, Villavicencio P, et al. Diagnostic accuracy of non-invasive markers for liver fat assessment in HIV patients. BMC
Gastroenterol. 2023;23:200. doi: 10.1186/s12876-023-02754-6
25. Sahuquillo-Martí´nez A, Ramí´rez-Manent J, Torres-Moreno P. La ecografí´a como te´cnica diagno´stica en esteatosis hepa´tica no alcoho´lica. JONNPR. 2020;5(4):12-15. doi: 10.19230/jonnpr.3261
26. Coronel ME, Coronel CM. Esteatohepatitis no alcoho´lica (EHNA). Rev Gastroenterol Peru. 2016;36(1):58-65. Disponible en: http://www.scielo.org.pe/scielo.php?script=sci_arttext&pid=S1022-51292016000100008
27. Moreau C, Girard L, Dupont S, et al. Pre´valence et facteurs de risque de la ste´atose he´patique chez les personnes vivant avec le VIH: une revue syste´matique. Rev Med Interne. 2023;58(6):451-459. doi:10.1016/j.revmed.2023.03.022
28. Martí´nez B, Garcí´a A, Rodrí´guez P, et al. Risk of non-alcoholic fatty liver disease in HIV-infected patients on antiretroviral therapy. BMC Infect Dis. 2023;23:152. doi: 10.1186/s12879-023-07162-9
29. Lo´pez-Vela´zquez JA, Silva-Vidal KV, Ponciano-Rodrí´guez G, Cha´vez-Tapia NC, Arrese M, Uribe M, et al. The prevalence of nonalcoholic fatty liver disease in the Americas. Ann Hepatol. 2014;13(2):166-178. doi:10.1016/S1665-2681(19)30840-8
30. Lombardi R, Airaghi L, Targher G, Serviddio G, Maffi G, Mantovani A, et al. Liver fibrosis by FibroScan independently of established cardiovascular risk parameters associates with macrovascular and microvascular complications in patients with type 2 diabetes. Nutr Metab Cardiovasc Dis. 2020;30(5):789798. doi: 10.1016/j.numecd.2019.12.007
31. Younossi ZM, Golabi P, Paik JM, Henry A, Van Dongen C, Henry L. Global epidemiology of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis: systematic review. Hepatology. 2023;77(4):1335-1347. doi: 10.1002/hep.32752
32. Maurice JB, Patel A, Scott AJ, Patel K, Thursz M, Lemoine M. Prevalence and risk factors of nonalcoholic fatty liver disease in HIV-monoinfection: a systematic review and meta-analysis. AIDS. 2017;31(11):1621-1632. doi: 10.1097/QAD.0000000000001502
33. Weber R, Sabin CA, Friis-Møller N, Reiss P, El-Sadr WM, Kirk O, et al.; D:A:D Study Group. Liver-related deaths in persons infected with the human immunodeficiency virus: the D:A:D study. Arch Intern Med. 2006;166(15):1632-1641. doi:
34. American Diabetes Association Professional Practice Committee. Comprehensive medical evaluation and assessment of comorbidities: Standards of Care in Diabetes—2023. Diabetes Care. 2023;46(Suppl 1):S49-S67. doi: 10.2337/dc23-S004
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Cristian Díaz Vélez, Yersin Silva Silva
This work is licensed under a Creative Commons Attribution 4.0 International License.
RICSA is an open access journal distributed under the terms and conditions of Creative Commons Attribution 4.0 International license
