Non-Alcoholic Fatty Liver Disease and Its Sarco-Metabolic Correlates in People Living with Human Immunodeficiency Virus Infection

Sep 29, 2026

Non-alcoholic fatty liver disease (NAFLD) and sarcopenia are increasingly recognized in people living with human immunodeficiency virus (PLHIV), elevating cardiometabolic risk. This study evaluates NAFLD prevalence and its sarco-metabolic associations among 60 clinically stable PLHIV on anti-retroviral therapy for more than one year. Hepatic inflammation, steatosis, and fibrosis were measured using FibroScan-based methods, while muscle strength and mass were assessed with dynamometry and dual-energy X-ray absorptiometry. Results showed NAFLD frequency of 20% and higher inflammation and triglycerides in NAFLD.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages8

Reading Time20 min

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Abstract

Introduction

Background and rationale

Methods

Results

Conclusion

Keywords

| Diabetes/Lipids/Obesity | | --- | | Original Article | Non‑Alcoholic Fatty Liver Disease and Its Sarco‑Metabolic Correlates in People Living with Human Immunodeficiency Virus Infection Ankush Garg1, Prayas Sethi1, Naval K. Vikram1, Neeraj Nischal1, Ved P. Meena1, Kumble S. Madhusudhan2, Shalimar3, Maroof A. Khan4, Sanjay Ranjan1, Naveet Wig1 Departments of 1Medicine, 2Radiodiagnosis and Interventional Radiology, 3Gastroenterology and Human Nutrition Unit and 4Biostatistics, All India Institute of Medical Sciences, New Delhi, India Abstract Introduction: Non‑alcoholic fatty liver disease (NAFLD) and sarcopenia are increasingly identified in People Living with Human Immunodeficiency Virus (HIV) (PLHIV), contributing to cardiometabolic risk. This study aims to assess the prevalence and sarcometabolic associations of NAFLD in PLHIV. Methods: The study included 60 clinically stable patients on anti‑retroviral treatment (>1 year) . Patients with liver diseases, Hepatitis B/C, and significant alcohol intake were excluded. Hepatic inflammation was assessed via FibroScan‑AST score (FAST), steatosis via Controlled Attenuation Parameter obtained from Fibroscan, and fibrosis using APRI, FIB‑4, and Liver Stiffness Measurement. Sarcopenia was assessed using hand grip strength measured using a hydraulic dynamometer and skeletal muscle mass via Dual‑Energy X‑ray Absorptiometry. Sarcometabolic parameters were compared between PLHIV with and without NAFLD. Results: The study enrolled 60 patients (mean age: 37.12 ± 9.26 years; 46 (76.67%) males) . The NAFLD frequency was 20%, with the majority having grade 3 steatosis. Hepatic inflammation (FAST score) was higher in NAFLD group (0.34 vs 0.12, P = 0.001). Obesity (body mass index) was significantly higher inNAFLD (66.67% vs 18.75%), P = 0.002}. The sarcopenia prevalence was 10%, with pre‑sarcopenia (low muscle mass) of 45% . The muscle strength and mass were higher in NAFLD patients but not statistically significant. High triglycerides was a significant NAFLD risk factor {adjusted OR: 5.75 (1.11–29.73)} . Conclusion: NAFLD prevalence in stable Indian PLHIV is significant considering a high cardiovascular disease risk in this population. Hypertriglyceridemia seems to be significantly associated as a risk factor. Return to health and nutrition have positively impacted muscle health with a downside of developing fatty liver. Keywords: Metabolic dysfunction, NAFLD, PLHIV, sarcopenia IntroductIon Acquired Immunodeficiency Syndrome (AIDS) caused by the Human Immunodeficiency Virus (HIV) remains a major public health issue in India. In 2021, approximately 24.01 lakh people were living with HIV (PLHIV) in India with a prevalence of 0.21% .[1] HIV has a profound effect on the human body, primarily the immune system. It can also cause neurological, cardiovascular, metabolic, and musculoskeletal complications. With the advent of anti‑retroviral therapy, life expectancy of PLHIV has increased significantly, leading to a shift in focus towards chronic non‑infectious complications . [1] Liver diseases, particularly non‑alcoholic fatty liver disease (NAFLD), which is considered as a harbinger of other metabolic disorders, have | Access this article online | | | --- | --- | | Quick Response Code:
| Website:
[https://journals.lww.com/indjem/](https://journals.lww.com/indjem/) | | | DOI:
10.4103/ijem.ijem_45_25 | become relevant in PLHIV, with evidence indicating a higher prevalence than the general population. NAFLD is characterised by the excess liver fat accumulation, which may progress to inflammation and fibrosis. Risk factors for NAFLD in PLHIV include HIV’s direct impact on the liver, anti‑retroviral treatment (ART)‑related metabolic Address for correspondence: Dr. Prayas Sethi, Department of Medicine, All India Institute of Medical Sciences, New Delhi ‑ 110 029, India. E‑mail: [prayassethi82@gmail.com](prayassethi82@gmail.com) Submitted: 29‑Jan‑2025 Accepte

FAQs

What was the main objective of the study in PLHIV?

To assess the prevalence of NAFLD and its sarco-metabolic associations in people living with human immunodeficiency virus (PLHIV).

How was NAFLD-related liver status evaluated in the study?

Hepatic inflammation was assessed using the FibroScan-AST (FAST) score, steatosis by FibroScan Controlled Attenuation Parameter, and fibrosis using APRI, FIB-4, and Liver Stiffness Measurement.

Which metabolic factor was identified as a significant risk factor for NAFLD?

High triglycerides were a significant NAFLD risk factor, with an adjusted OR of 5.75 (1.11–29.73).

Sep 29, 2026

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