The authors have declared that no competing interests exist.
Hepatic steatosis may occur with any type of HAART. Recently genome wide association studies have identified 5 single nucleotide polymorphisms (SNPs) predisposing to fatty liver disease in nutritional abnormalities. Using a non-invasive method termed “controlled attenuation parameter” we assessed liver fat in HAART-treated HIV-patients and correlated hepatic steatosis to genotype distribution of the 5 SNPs. Unlike alimentary fatty liver our data do not support a role of these SNPs for fatty liver disease on HAART.
Highly active antiretroviral therapy has dramatically reduced death rates from opportunistic diseases but is frequently complicated by dyslipidaemia and fatty liver disease (1). Although certain reverse transcriptase inhibitory nucleotides such as the “D” drugs didanosine and stavudine carry a particularly high risk of hepatic steatosis, fatty liver disease has been observed with any type of antiretroviral therapy. Recently two genome wide association studies have revealed that single nucleotide polymorphisms in or near the five genes
We recruited 57 HIV-infected patients (median age: 48 years, range 30 – 72 years; 8 females) into this pilot study. Patients were on HAART for a median of 81 months (range 6 – 275 months) and had a median of 468 CD4+ cells/µl (range 128-1474 cells/µl). At the time of the study 31 and 26 patients were taking a NNRTI- and PI-based antiretroviral therapy, and 33 and 29 patients had prior exposure to PIs and D-drugs, respectively. 152 healthy volunteers (median age 39 years, range 21-67 years; 59 females) served as reference for the distribution of alleles in the background population. Informed consent was obtained from all patients prior to sample acquisition, and the study was approved by the local ethics committee of the University of Bonn, Germany. Genomic DNA was extracted from 200 μl EDTA-blood using the QIAamp Blood Mini Kit (Qiagen, Hilden, Germany) according to the manufacturer’s protocol. Determination of the
and hepatic steatosis in our HIV patients. This finding suggests that unlike alcohol consumption or non-alcoholic steatohepatitis genetic variants in
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Healthy Controls | 87 | 55 | 10 | 24.70% |
57% | 36% | 7% | ||
HIV-Patients (all) | 34 | 21 | 2 | 21.90% |
60% | 37% | 4% | ||
HIV-Patients without fatty liver disease( <238dB/m) | 22 | 11 | 2 | 21.40% |
63% | 31% | 6% | ||
HIV-Patients with fatty liver disease (438 dB/m) | 12 | 10 | 0 | 22.70% |
55% | 45% | 0% | ||
HIV-Patients with severe fatty liver disease (>260 dB/m) | 6 | 6 | 0 | 25.00% |
50% | 50% | 0% | ||
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Healthy Controls | 128 | 23 | 1 | 8.20% |
84% | 15% | 1% | ||
HIV-Patients (all) | 46 | 11 | 0 | 9.60% |
81% | 19% | 0% | ||
HIV-Patients without fatty liver disease( <238dB/m) | 30 | 5 | 0 | 7.10% |
86% | 14% | 0% | ||
HIV-Patients with fatty liver disease (438 dB/m) | 16 | 6 | 0 | 13.60% |
73% | 27% | 0% | ||
HIV-Patients with severe fatty liver disease (>260 dB/m) | 9 | 3 | 0 | 12.50% |
75% | 25% | 0% | ||
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Healthy Controls | 53 | 77 | 22 | 39.80% |
35% | 51% | 15% | ||
HIV-Patients (all) | 21 | 29 | 7 | 37.70% |
37% | 51% | 12% | ||
HIV-Patients without fatty liver disease( <238dB/m) | 14 | 18 | 3 | 34.30% |
40% | 51% | 9% | ||
HIV-Patients with fatty liver disease (438 dB/m) | 7 | 11 | 4 | 43.20% |
32% | 50% | 18% | ||
HIV-Patients with severe fatty liver disease (>260 dB/m) | 3 | 9 | 0 | 37.50% |
25% | 75% | 0% | ||
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Healthy Controls | 127 | 25 | 0 | 8.20% |
84% | 16% | 0% | ||
HIV-Patients (all) | 44 | 13 | 0 | 11.40% |
77% | 23% | 0% | ||
HIV-Patients without fatty liver disease( <238dB/m) | 27 | 8 | 0 | 11.40% |
77% | 23% | 0% | ||
HIV-Patients with fatty liver disease (438 dB/m) | 17 | 5 | 0 | 11.40% |
77% | 23% | 0% | ||
HIV-Patients with severe fatty liver disease (>260 dB/m) | 8 | 4 | 0 | 16.70% |
67% | 33% | 0% | ||
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Healthy Controls | 109 | 39 | 4 | 15.50% |
72% | 26% | 3% | ||
HIV-Patients (all) | 37 | 18 | 2 | 19.30% |
65% | 32% | 4% | ||
HIV-Patients without fatty liver disease( <238dB/m) | 24 | 10 | 1 | 17.10% |
69% | 29% | 3% | ||
HIV-Patients with fatty liver disease (438 dB/m) | 13 | 8 | 1 | 22.70% |
59% | 36% | 5% | ||
HIV-Patients with severe fatty liver disease (>260 dB/m) | 6 | 6 | 0 | 25.00% |
50% | 50% | 50% |