3TC-DTG Dual Therapy and Its Implications in Hepatic Steatosis in People Living With HIV

Abstract

1.1. Purpose: Hepatic disease is one of the major comorbidities in people living with HIV. We intended to define the incidence of NAFLD and to identify any factors which may be associated with such a condition. Methods:We performed abdominal Ultra Sound (US) on people living with HIV at our clinical center. Detection and grading of hepatic steatosis were based on the assessment of liver echogenicity. The grade of hepatic fibrosis was evaluated via Fib-4. About the patients analyzed, we collected baseline characteristics as well as HIV clinical history and liver function tests at the time of visit. Those with a history of chronic hepatitis (viral or alcoholic) were excluded. We then compared parameters through non-parametric tests and linear regression, as appropriate. Results:We analyzed 72 patients: 51 (71%) were males, with a median age of 48 years (IQR 41-55), a median time from HIV diagnosis of 10 years (IQR 4-18) and a median time on ARV of 8 years . Thirty patients (41.7%) presented a radiologic pattern of steatosis: 15 presented mild steatosis, 13 moderate and 2 severe steatoses. In our cohort, in a multivariate analysis, we found that the condition of steatosis was predicted by a previous baseline AIDS event (p=0.009) and a higher baseline GPT value (p=0.029); conversely, being on a dual regimen with 3TC+DTG (p=0.05) was inversely associated with hepatic steatosis, after adjusting for age, sex and HIV risk factor. Conclusion:A dual regimen of DTG+3TC appears less likely to be associated with hepatic steatosis.