Objective To describe the prevalence and factors associated with nonalcoholic fatty liver disease (NAFLD) among HIV-infected persons not infected with hepatitis C virus (HCV). Design A cross-sectional study among HIV-infected patients in a large HIV clinic. Methods NAFLD was defined as steatosis among patients without viral hepatitis (B or C) co-infection or excessive alcohol use. The prevalence of NAFLD was identified by ultrasound examination evaluated by two radiologists blinded to the clinic information; liver biopsies were performed on a subset of the study population. Factors associated with NAFLD evaluated by proportional odds logistic regression models. Results Sixty-seven (31%) of 216 patients had NAFLD based on ultrasound evaluation. Among those with NAFLD, steatosis was graded as mild in 60%, moderate in 28%, and severe/ marked in 12%. Factors associated with the degree of steatosis on ultrasound examination in the multivariate model included increased waist circumference (odds ratio [OR] 2.1 per 10 cm, p<0.001), elevated triglycerides (OR= 1.2 per 100 mg/dl, p=0.03), and lower HDL levels (OR 0.7, p=0.03). African Americans were less likely to have NAFLD compared to Caucasians (14% vs. 35%), although this did not reach statistical significance (OR= 0.4, p=0.08). Similar associations were noted for the subset of patients diagnosed by liver biopsy. CD4 cell count, HIV viral load, duration of HIV infection, and antiretroviral medications were not independent risk factors associated with NAFLD after adjustment for dyslipidemia or waist circumference. Conclusion NAFLD was common among this cohort of HIV-infected, HCV-seronegative patients. NAFLD was associated with a greater waist circumference, low HDL and high triglyceride levels. Antiretroviral medications were not associated with NAFLD; prospective studies are needed to confirm this finding.

Glutamate release from rod photoreceptors is dependent on a sustained calcium influx through L-type calcium channels. Missense mutations in the CACNA1F gene in patients with incomplete X-linked congenital stationary night blindness implicate the Ca v 1.4 calcium channel subtype. Here, we describe the functional and pharmacological properties of transiently expressed human Ca v 1.4 calcium channels. Ca v 1.4 is shown to encode a dihydropyridine-sensitive calcium channel with unusually slow inactivation kinetics that are not affected by either calcium ions or by coexpression of ancillary calcium channel ␤ subunits. Additionally, the channel supports a large window current and activates near Ϫ40 mV in 2 mM external calcium, making Ca v 1.4 ideally suited for tonic calcium influx at typical photoreceptor resting potentials. Introduction of base pair changes associated with four incomplete X-linked congenital night blindness mutations showed that only the G369D alteration affected channel activation properties. Immunohistochemical analyses show that, in contrast with previous reports, Ca v 1.4 is widely distributed outside the retina, including in the immune system, thus suggesting a broader role in human physiology.

Tumour size and operation year were significant predictors of facial nerve outcome. The surgical learning curve was steepest for the first 50 patients.

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