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. 2023 Dec;24(12):1233-1243.
doi: 10.1111/hiv.13579. Epub 2023 Nov 17.

Impact of steatotic liver disease and non-alcoholic steatohepatitis on cognitive impairment in people living with HIV: A cross-sectional study

Win Min Han  1   2   3 , Akarin Hiransuthikul  1   4 , Kathryn B Holroyd  5 , Tanakorn Apornpong  1 , Hay Mar Lwin  1 , Sivaporn Gatechompol  1   3 , Sasiwimol Ubolyam  1   3 , Stephen Kerr  1   2   6 , Anchalee Avihingsanon  1   3 ; HIV-NAT 006 study team and 207 study team
Collaborators, Affiliations

Impact of steatotic liver disease and non-alcoholic steatohepatitis on cognitive impairment in people living with HIV: A cross-sectional study

Win Min Han et al. HIV Med. 2023 Dec.

Abstract

Introduction: The link between fatty liver diseases and cognitive impairment among people living with HIV (PLWH) remains unclear. We investigated the association of steatotic liver disease (SLD), advanced liver fibrosis and non-alcoholic steatohepatitis (NASH) with significant activity and liver fibrosis with cognitive impairment in PLWH.

Methods: Cognitive performance was assessed for PLWH aged ≥50 years on stable antiretroviral therapy (ART) with the Thai-validated version of the Montreal Cognitive Assessment (MoCA), and a cut-off of <25/30 was used to define cognitive impairment. SLD and NASH with significant activity and liver fibrosis were defined as having a controlled attenuation parameter value ≥248 dB/m and a FibroScan-AST (FAST) score ≥0.67, respectively. Multivariable logistic regression was employed to investigate the association of cognitive impairment with SLD or NASH.

Results: Of the 319 PLWH (63.3% male and 98% had HIV-1 RNA ≤50 copies/mL) included, 74 (38%) had SLD. NASH with significant activity and liver fibrosis was present in 66 (20.1%) participants. Some 192 (60.2%) participants had cognitive impairment. In a multivariable analysis, NASH with significant activity and liver fibrosis was significantly associated with cognitive impairment (adjusted odds ratio [aOR] 2.01, 95% CI 1.02-3.98, p = 0.04), after adjusting for HIV-related parameters, age, sex, body mass index, employment status, education, income level, smoking, alcohol use, diabetes mellitus, hypertension and HIV-related parameters. The association of a lone diagnosis of SLD and cognitive impairment was not statistically significant.

Conclusions: NASH with significant activity and liver fibrosis was associated with lower cognitive performance, even after controlling for demographics and HIV disease parameters. Additional research is needed to better understand the underlying mechanisms.

Keywords: cognitive impairment; fatty liver; human immunodeficiency virus; non-alcoholic steatohepatitis; steatotic liver disease.

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References

REFERENCES

    1. Younossi Z, Tacke F, Arrese M, et al. Global perspectives on nonalcoholic fatty liver disease and nonalcoholic steatohepatitis. Hepatology. 2019;69(6):2672-2682.
    1. Maurice JB, Patel A, Scott AJ, Patel K, Thursz M, Lemoine M. Prevalence and risk factors of nonalcoholic fatty liver disease in HIV-monoinfection. AIDS. 2017;31(11):1621-1632.
    1. Kaya E, Yilmaz Y. Metabolic-associated fatty liver disease (MAFLD): a multi-systemic disease beyond the liver. J Clin Transl Hepatol. 2022;10(2):329-338.
    1. Masyuko SJ, Page ST, Polyak SJ, et al. Human immunodeficiency virus is associated with higher levels of systemic inflammation among Kenyan adults despite viral suppression. Clin Infect Dis. 2021;73(7):e2034-e2042.
    1. Maciel RA, Klück HM, Durand M, Sprinz E. Comorbidity is more common and occurs earlier in persons living with HIV than in HIV-uninfected matched controls, aged 50 years and older: a cross-sectional study. Int J Infect Dis. 2018;70:30-35.

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