Liver Disease

Hepatic Steatosis Is Less Common Among People With HIV vs General Population

Compared with the general population, people with HIV do not have an increased risk of moderate to severe hepatic steatosis, according to a new analysis of the Copenhagen Co-Morbidity Liver study.

To conduct the study, the research team compared 453 participants in the Copenhagen Co-Morbidity in HIV Infection study with 765 participants in the Copenhagen General Population Study. Participants did not have prior or current viral hepatitis or excessive alcohol intake at baseline.

Hepatic steatosis severity was defined via unenhanced computed tomography, and adjusted logistic regression was used to determine the adjusted odds ratios (aORs).

The results showed a lower prevalence of moderate to severe hepatic steatosis among participants with HIV (8.6%) vs the general population (14.2%).

“In multivariable analyses, HIV (aOR, 0.44; P < .01), female sex (aOR, 0.08; P = .03), physical activity level (aOR, 0.09; very active vs inactive; P < .01), and alcohol (aOR, 0.89 per unit/week; P = .02) were protective factors,” the researchers wrote.

They also noted that body mass index (BMI), alanine transaminase (ALT), and exposure to integrase inhibitors increased the risk of moderate to severe hepatic steatosis.

“Moderate to severe hepatic steatosis is less common in [people with HIV] compared with demographically comparable uninfected controls. Besides BMI and ALT, integrase inhibitor exposure was associated with higher prevalence of steatosis in [people with HIV].”

—Amanda Balbi


Kirkegaard-Klitbo DM, Fuchs A, Stender S, et al. Prevalence and risk factors of moderate-to-severe hepatic steatosis in human immunodeficiency virus infection: the Copenhagen co-morbidity liver study. J Infect Dis. 2020;222(8):1353-1362.