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Volume 41 Issue 11
Nov.  2025
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Article Navigation >  Journal of Clinical Hepatology  > 2025  >  41(11): 2294-2299

Changes in metabolic markers and the risk of new-onset metabolic associated fatty liver disease in previously untreated patients with HIV infection after lamivudine/efavirenz/tenofovir disoproxil fumarate treatment

DOI: 10.12449/JCH251115
  • 1.

    Department of Infectious Diseases，Hubei AIDS Clinical Guidance Training Center，Zhongnan Hospital of Wuhan University，Wuhan 430071，China

  • 2.

    Wuhan Research Center for Infectious Diseases and Cancer，Chinese Academy of Medical Sciences，Wuhan 430071，China

Research funding:

National Natural Science Foundation of China (81572902)

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  • Corresponding author: KE Hengning， kehengning@znhospital.cn （ORCID： 0000-0003-1185-5402）
  • Received Date: 2025-05-14
  • Accepted Date: 2025-06-16
  • Published Date: 2025-11-25
    Abstract
  •   Objective  To investigate the impact of metabolic associated fatty liver disease （MAFLD） on metabolic markers in patients with HIV infection， and to assess the risk of new-onset MAFLD in previously untreated HIV patients.  Methods  A total of 161 HIV patients who attended the outpatient service of Zhongnan Hospital of Wuhan University from April 2020 to December 2021 were enrolled， and they were treated with the lamivudine/efavirenz/tenofovir disoproxil fumarate （3TC/EFV/TDF） regimen and were followed up for more than 36 months. According to the presence or absence of MAFLD， they were divided into MAFLD group with 42 patients and non-MAFLD group with 119 patients， and metabolic markers were compared between the two groups before and after treatment. The independent-samples t test was used for comparison of normally distributed continuous data between two groups， and the paired t-test was used for comparison within each group before and after treatment； the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups， and the Wilcoxon signed-rank test was used for comparison within each group before and after treatment； the chi-square test was used for comparison of categorical data between groups. Hepatic steatosis index （HIS） and Zhejiang University （ZJU） index were used to assess the risk of new-onset MAFLD after antiretroviral therapy.  Results  After 36 months of 3TC/EFV/TDF treatment， the MAFLD group had significant increases in body mass index （BMI） ［24.8 （23.2 — 25.9） kg/m2 vs 25.3 （22.8 — 27.7） kg/m2， Z=-2.540， P=0.011］， total cholesterol （TC） （4.0±0.6 mmol/L vs 4.3±0.6 mmol/L， t=-2.388， P=0.022）， and high-density lipoprotein cholesterol （HDL-C） ［0.9 （0.8 — 1.1） mmol/L vs 1.1 （0.9 — 1.2） mmol/L， Z=-2.858， P=0.004］ and a significant reduction in serum uric acid （462.1±101.6 μmol/L vs 383.3±85.2 μmol/L， t=4.361， P<0.001）. There was a significant difference in BMI between the MAFLD group and the non-MAFLD group after 3TC/EFV/TDF treatment ［25.3 （22.8 — 27.7） kg/m2 vs 21.6 （19.9 — 23.4） kg/m2， Z=-5.462， P<0.001］， while there were no significant differences between the two groups in serum uric acid， TC， triglyceride， HDL-C， low-density lipoprotein cholesterol， lipoprotein a， and CD4+ T cell count （all P >0.05）. Furthermore， for the patients in the non-MAFLD group after treatment， there was a significant increase in the proportion of patients at a high risk of MAFLD based on HSI and ZJU indices （χ²=10.829 and 5.658， P=0.001 and 0.017）.  Conclusion  After 36 months of 3TC/EFV/TDF treatment， there are increases in blood lipid levels in HIV patients with MAFLD， and there is an increase in the risk of new-onset MAFLD in HIV patients without MAFLD.

     

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