How NAFLD Affects Patients With HIV Differently Than the General Public

In this video, Lindsay T. Fourman, MD, talks about how nonalcoholic fatty liver disease affects patients with HIV differently than it affects the general public. 

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Lindsay T. Fourman, MD, is a physician at Massachusetts General Hospital in Boston, Massachusetts.



Lindsay T. Fourman: NAFLD affects about a third of all people living with HIV, which is a very high percent. Many patients are being affected by this, and the fact that we saw fibrosis presence in such a high proportion, about 40%, really suggests that a very high percent are having liver complications related to NAFLD and are at risk of progression of their NAFLD as well.

In terms of how this differs from the general population, in terms of the severity of the disease, studies have shown that it does appear to be more severe, that there is a higher percent of people with NASH and with fibrosis and HIV compared to the general population. In addition, our data add to this by also showing very high rates of fibrosis progression.

As I said, we saw a 38% prevalence of fibrosis progression in our sample, and we saw that the increase in stages overall per year in fibrosis was about 0.2 stages per year, compared to the general population, which has been quoted to be about an increase in 0.03 stages per year.

That's about a 6‑fold increased rate of progression of fibrosis in HIV compared to the general population. As I said at the beginning, fibrosis is really the most important predictor of mortality related to NAFLD. This endpoint indicates that the disease is much more aggressive in HIV compared to non‑HIV.

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