Penelope C Rose, Claire Davies, Mark F Cotton, Kennedy Otwombe, Sara H Browne, Florin Vaida, Steve Innes, Etienne De la Rey Nel
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引用次数: 0
Abstract
Objectives: Metabolic dysfunction-associated steatotic liver disease (MASLD) is an emerging cause of liver disease in HIV. Transient elastography (TE) with controlled attenuation parameter (CAP) measures liver stiffness as a marker of liver fibrosis and CAP as a measure of hepatic steatosis. Our aim was to evaluate longitudinal CAP and liver stiffness in children with perinatally acquired HIV (PHIV) on antiretroviral therapy (ART) from early life compared to children without HIV (HU).
Design: Prospective cohort study.
Methods: PHIV and HU were followed annually for two years. During the study, 60% of PHIV switched from older ART regimens to tenofovir disoproxil, lamivudine and dolutegravir (TLD). Longitudinal evolution of CAP and liver stiffness were investigated in two PHIV groups - on older ART and on TLD - compared to HU children using linear mixed effects models.
Results: 263 children and adolescents (112 PHIV, 151 HU) aged 7-20 years were followed. PHIV on older ART had CAP 8.61% (95% CI 4.42-12.97, P < 0.001) greater than HU and no significant difference in CAP between PHIV on TLD and HU. No significant difference in liver stiffness was found between PHIV on older ART regimens and PHIV on TLD compared to HU.
Conclusion: PHIV on older ART had higher CAP than HU, whereas in PHIV switched to TLD there was no difference in CAP compared to HU. There was no difference in liver stiffness between either PHIV group and HU. This suggests starting ART early in life might protect PHIV from developing hepatic fibrosis.
目的：代谢功能障碍相关性脂肪性肝病（MASLD）是新出现的艾滋病肝病病因。带有控制衰减参数（CAP）的瞬态弹性成像（TE）可测量肝脏硬度，作为肝纤维化的标志，而CAP则可测量肝脏脂肪变性。我们的目的是评估围产期感染艾滋病病毒（PHIV）的儿童与未感染艾滋病病毒的儿童（HU）相比，从生命早期就开始接受抗逆转录病毒疗法（ART）的儿童的纵向 CAP 和肝脏硬度：设计：前瞻性队列研究：方法：每年对 PHIV 和 HU 进行为期两年的跟踪调查。研究期间，60%的PHIV从旧的抗逆转录病毒疗法转为替诺福韦酯、拉米夫定和多罗替拉韦（TLD）疗法。研究采用线性混合效应模型，调查了两组 PHIV（接受老式抗逆转录病毒疗法的 PHIV 和接受 TLD 的 PHIV）与 HU 儿童相比，CAP 和肝硬变的纵向演变情况。接受老式抗逆转录病毒疗法的 PHIV 患有 CAP 的比例为 8.61%（95% CI 为 4.42% 至 12.97%，P 结论：接受老式抗逆转录病毒疗法的 PHIV 患有 CAP 的比例较高：接受老式抗逆转录病毒疗法的 PHIV 的 CAP 比 HU 高，而改用 TLD 的 PHIV 的 CAP 与 HU 相比没有差异。PHIV 组和 HU 组的肝脏硬度没有差异。这表明，早期开始抗逆转录病毒疗法可能会保护 PHIV 免于发展成肝纤维化。
期刊介绍：
Publishing the very latest ground breaking research on HIV and AIDS. Read by all the top clinicians and researchers, AIDS has the highest impact of all AIDS-related journals. With 18 issues per year, AIDS guarantees the authoritative presentation of significant advances. The Editors, themselves noted international experts who know the demands of your work, are committed to making AIDS the most distinguished and innovative journal in the field. Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.
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