Several podcasts by Dr. Fourman on consultant360 https://www.consultant360.com/exclusive/infectious-diseases/transcript-how-nafld-affects-patients-hiv-differently-general-public
“As I said, we saw a 38% prevalence of fibrosis progression in our sample, and we saw that the increase in stages overall per year in fibrosis was about 0.2 stages per year, compared to the general population, which has been quoted to be about an increase in 0.03 stages per year.
That's about a 6fold increased rate of progression of fibrosis in HIV compared to the general population. As I said at the beginning, fibrosis is really the most important predictor of mortality related to NAFLD. This endpoint indicates that the disease is much more aggressive in HIV compared to nonHIV.”
https://www.consultant360.com/exclusive/infectious-diseases/transcript-clinical-predictors-liver-fibrosis-presence-and
“We recently completed a randomized placebocontrolled trial of a medication called tesamorelin to treat fatty liver in HIV. Tesamorelin is a growth hormone, releasing hormone analog that's FDA approved to treat visceral fat. We also wanted to know whether or not it can reduce liver fat in HIV.
This previous study provided us with a framework to look at the longterm natural history of NAFLD in HIV, particularly, should we go on to develop fibrosis, since we had serial liver biopsies on all of our patients, and in particular, on the placebotreated arm.
Overall, the presence of fibrosis was seen in about 40% of individuals, so a very high percent, consistent with previous reports in HIV that have shown that NAFLD does tend to be more severe in this population.”
https://www.consultant360.com/exclusive/infectious-diseases/transcript-take-away-messages-about-liver-fibrosis-patients-hivnafld
“Given that people with HIV tend to have increased visceral fat accumulation, this could account for why there is such a high progression rate of fibrosis in people with NAFLD and HIV.”
https://www.consultant360.com/exclusive/infectious-diseases/predictors-liver-fibrosis-hiv-identified
“High rates of liver fibrosis presence and progression were observed in a cohort with HIV and NAFLD. Individuals with greater visceral fat content at baseline were more likely to have baseline fibrosis and progression of fibrosis, suggesting that these patients should be closely monitored and targeted for intervention,” the researchers concluded.”