Screening and Follow-up in Patients With HIV Infection Combined With Metabolic Associated Fatty Liver Disease

NCT ID: NCT05330923

Last Updated: 2025-12-09

Basic Information

• Recruitment Status: RECRUITING
• Total Enrollment: 200 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2022-05-01
• Study Completion Date: 2029-06-01

Brief Summary

Identifying patients at risk of NAFLD(Nonalcoholic fatty liver disease), especially severe disease with NASH(nonalcoholic steatohepatitis) and fibrosis, is critical. Prevalence of NAFLD in PLWH(People Living With HIV) evaluated by different imaging techniques including US (ultrasonography), elastography, CT(computed tomography ), and magnetic resonance varies from 13% to 58.6% in all published studies. In previous studies, the effect of ART(Anti-Retroviral Therapy) on NAFLD was limited. A cross-sectional analysis found that INSTI（Integrase strand transfer inhibitor） was associated with a higher prevalence of steatosis in AIDS (acquired immunodeficiency syndrome) patients. However, it is not clear whether there is a difference in the degree of nonalcoholic steatosis between AIDS patients receiving NNRTI(non-nucleoside reverse transcriptase inhibitors).

Therefore, the investigators plan to conduct a prospective study to assess whether there is any difference in the degree of nonalcoholic steatosis and fibrosis between Chinese HIV(human immunodeficiency virus)/AIDS patients after initial treatment with NNRTI or INSTI, or switching from NNRTI to INSTI.

Detailed Description

Chronic liver disease is now a leading cause of non-AIDS-related death, representing 13% of all deaths in this patient population. While coinfection with viral hepatitis is the primary cause of liver disease, hepatic steatosis is emerging as a major contributor. NAFLD is defined by liver steatosis, the accumulation of triglycerides in the hepatocytes, in the absence of a secondary cause such as excessive alcohol consumption. The condition encompasses a spectrum of diseases from nonalcoholic fatty liver to NASH, fibrosis and cirrhosis. Recent studies report a wide range of prevalence of NAFLD between 15% and 60% among HIV patients. In non-HIV patients NAFLD is principally the hepatic manifestation of the metabolic syndrome, occurring in the context of insulin resistance, central obesity and dyslipidaemia, with disease progression involving a number of complex interacting factors such as genetic susceptibility, oxidative stress and dysbiosis. There is a growing body evidence for weight gain following initiating integrase inhibitor therapy, particularly with dolutegravir and bictegravir. However, the consequences of weight gain have not been evaluated.

Identifying patients at risk of NAFLD, especially severe disease with NASH and fibrosis, is critical. Prevalence of NAFLD in PLWH evaluated by different imaging techniques varies from 13% to 58.6% in all published studies. In previous studies, the effect of ARTon NAFLD was limited. A cross-sectional analysis found that INSTI was associated with a higher prevalence of steatosis in AIDS patients. However, it is not clear whether there is a difference in the degree of nonalcoholic steatosis between AIDS patients receiving NNRTI.

Transient elastography is a non-invasive technique to measure UAP(ultrasound attenuation parameter)and liver stiffness simultaneously. The former reflects the degree of hepatic steatosis. The typical features of fatty liver on abdominal ultrasonography include bright liver echotexture, deep attenuation of ultrasound signal and vascular blunting. The latter two features are because of the faster attenuation of ultrasound wave amplitude in a steatotic liver. UAP takes advantage of this physical property and estimates the ultrasound attenuation at the central frequency of transient elastography, while assuming a homogeneous fat distribution and an adequate penetration.

Therefore, the investigators plan to conduct a prospective study to assess whether there is any difference in the degree of nonalcoholic steatosis and fibrosis between Chinese HIV/AIDS patients after initial treatment with NNRTI or INSTI, or switching from NNRTI to INSTI.

Conditions

Nonalcoholic Fatty Liver Disease; Nonalcoholic Steatohepatitis; Fibrosis; HIV/AIDS

Study Design

• Observational Model Type: CASE_ONLY
• Study Time Perspective: CROSS_SECTIONAL

Eligibility Criteria

Inclusion Criteria

• Newly treated or treated AIDS patients;
• Regular follow-up visits to the hospital, medication compliance is good;
• Patients or their family members were willing to participate in the study by understanding the study plan and providing written informed consent.

Exclusion Criteria

• Unable to complete the position requirements of ultrasonic examination (lying flat) due to mobility difficulties;
• Patients have poor compliance and cannot follow up regularly or take medicine on time;
• Patients or family members cannot understand the conditions and objectives of the study;
• Other conditions considered unsuitable for inclusion by the investigator.

• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Wuxi Hisky Medical Technology Co Ltd

INDUSTRY

Sponsor Role: collaborator

Peking Union Medical College Hospital

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

WEI Lyu

Role: PRINCIPAL_INVESTIGATOR

Department of Infectious Diseases, PekingUMCH

Locations

Chinese Academy of Medical Sciences Peking Union Medical College Hospital

Beijing, Beijing Municipality, China

Site Status: RECRUITING

Countries

China

Central Contacts

QING ZHANG

Role: CONTACT

zhangqingpumch@163.com

15001278131 ext. +86

Facility Contacts

QING ZHANG

Role: primary

15001278131 ext. +86

Other Identifiers

PekingUMCH record HS-3401D

Identifier Type: -

Identifier Source: org_study_id