{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T17:13:38Z","timestamp":1790874818301,"version":"4.1.0"},"reference-count":51,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,4,2]],"date-time":"2024-04-02T00:00:00Z","timestamp":1712016000000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Liver disease is a leading cause of morbidity and mortality among persons living with HIV (PLHIV). While chronic viral hepatitis has been extensively studied in low\u2010 and middle\u2010income countries (LMICs), there is limited information about the burden of metabolic disorders on liver disease in PLHIV.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a cross\u2010sectional analysis of baseline data collected between October 2020 and July 2022 from the IeDEA\u2010Sentinel Research Network, a prospective cohort enrolling PLHIV \u226540 years on antiretroviral treatment (ART) for \u22656 months from eight clinics in Asia, Americas, and central, East, southern and West Africa. Clinical assessments, laboratory testing on fasting blood samples and liver stiffness measurement (LSM)\/controlled attenuation parameter (CAP) by vibration\u2010controlled transient elastography were performed. Multivariable logistic regression models assessed factors associated with liver fibrosis (LSM \u22657.1 kPa) and steatosis (CAP \u2265248 dB\/m). Population attributable fraction (PAF) of each variable associated with significant liver fibrosis was estimated using Levin's formula.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 2120 PLHIV (56% female, median age 50 [interquartile range: 45\u221256] years) were included. The prevalence of obesity was 19%, 12% had type 2 diabetes mellitus (T2DM), 29% had hypertension and 53% had dyslipidaemia. The overall prevalence of liver fibrosis and steatosis was 7.6% (95% confidence interval [CI] 6.1\u22128.4) and 28.4% (95% CI 26.5\u221230.7), respectively, with regional variability. Male sex at birth (odds ratio [OR] 1.62, CI 1.10\u22122.40), overweight\/obesity (OR = 2.50, 95% CI 1.69\u22123.75), T2DM (OR 2.26, 95% CI 1.46\u22123.47) and prolonged exposure to didanosine (OR 3.13, 95% CI 1.46\u22126.49) were associated with liver fibrosis. Overweight\/obesity and T2DM accounted for 42% and 11% of the PAF for liver fibrosis, while HBsAg and anti\u2010HCV accounted for 3% and 1%, respectively. Factors associated with steatosis included overweight\/obesity (OR 4.25, 95% CI 3.29\u22125.51), T2DM (OR 2.06, 95% CI 1.47\u22122.88), prolonged exposure to stavudine (OR 1.69, 95% CI 1.27\u22122.26) and dyslipidaemia (OR 1.68, 95% CI 1.31\u22122.16).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Metabolic disorders were significant risk factors for liver disease among PLHIV in LMICs. Early recognition of metabolic disorders risk factors might be helpful to guide clinical and lifestyle interventions. Further prospective studies are needed to determine the causative natures of these findings.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.26238","type":"journal-article","created":{"date-parts":[[2024,4,3]],"date-time":"2024-04-03T06:30:10Z","timestamp":1712125810000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Metabolic causes of liver disease among adults living with HIV from low\u2010 and middle\u2010income countries: a cross\u2010sectional study"],"prefix":"10.1002","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0446-1827","authenticated-orcid":false,"given":"Marie Kerbie","family":"Plaisy","sequence":"first","affiliation":[{"name":"University\u00a0of Bordeaux, National Institute for Health and Medical Research (INSERM) UMR\u00a01219, Research Institute for Sustainable Development (IRD) EMR 271,\u00a0Bordeaux\u00a0Population Health Centre  Bordeaux 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