Objective: To describe the prevalence of non-alcoholic fatty liver disease (NAFLD) in people living with HIV in Taizhou, Zhejiang Province, and identify the factors associated with NAFLD in this population. Methods: A cross-sectional survey was conducted from 2021 to 2023. Based on the routine follow-up management of people living with HIV, liver ultrasound examination, physical examination and laboratory test were conducted to collect the information about the diagnosis of NAFLD and biochemical indicators in this population. Logistic regression model was used to identify the factors associated with the prevalence of NAFLD. Results: In the 2 550 study participants, the prevalence of NAFLD was 21.5% (548/2 550), abnormal liver function was found in 23.7% (604/2 550) of the study participants, and liver fibrosis was found in 45.2% (1 152/2 550) of the study participants. Multivariable logistic regression analyses showed that being women (aOR=0.55, 95%CI: 0.42-0.73), being overweight or obese (aOR=3.22, 95%CI: 2.59-4.01), having diabetes (aOR=3.37, 95%CI: 2.15-5.29), having dyslipidemia (aOR=2.96, 95%CI: 2.25-3.89), CD4+ T lymphocyte (CD4) counts <200 cells/µl (aOR=0.61, 95%CI: 0.42-0.88), and receiving Efavirenz (EFV) + Lamivudine (3TC) + Zidovudine (AZT) for antiretroviral therapy (ART)(aOR=1.52, 95%CI: 1.17-1.98) were associated with NAFLD. NAFLD was positively associated with abnormal liver function (aOR=2.01, 95%CI: 1.60-2.52) and inversely associated with liver fibrosis (aOR=0.76, 95%CI: 0.59-0.98). The 45-59 age group (aOR=7.05, 95%CI: 5.65-8.80), CD4 counts <200 cells/μl (aOR=1.45, 95%CI: 1.06-1.97) and receiving Nevirapine (NVP)+3TC+AZT of ART (aOR=1.87,95%CI: 1.44-2.43) were the main factors associated with liver fibrosis. Conclusions: The prevalence of NAFLD in people living with HIV Taizhou was more than 20.0%, with a significant proportion of them having abnormal liver function and liver fibrosis. Being overweight or obese, suffering from diabetes, having dyslipidemia, low CD4 counts, and receiving specific ART were associated with NAFLD. NAFLD, CD4 counts and specific ART were the main factors associated with abnormal liver function and liver fibrosis.
目的： 分析浙江省台州市HIV感染者非酒精性脂肪性肝病（NAFLD）的患病情况及相关因素。 方法： 于2021-2023年开展横断面调查，依托HIV感染者常规随访管理工作开展肝脏B超检查、体格检查和实验室检测，获得NAFLD诊断、生化指标等信息。采用logistic回归模型分析HIV感染者中NAFLD患病的相关因素。 结果： 在2 550例研究对象中，NAFLD患病率为21.5%（548/2 550），肝功能异常的比例为23.7%（604/2 550），肝纤维化的比例为45.2%（1 152/2 550）。多因素logistic回归分析结果显示，女性（aOR=0.55，95%CI：0.42~0.73）、超重及肥胖（aOR=3.22，95%CI：2.59~4.01）、糖尿病（aOR=3.37，95%CI：2.15~5.29）、血脂异常（aOR=2.96，95%CI：2.25~3.89）、CD4+T淋巴细胞（CD4）计数<200个/µl（aOR=0.61，95%CI：0.42~0.88）和使用依非韦伦（EFV）+拉米夫定（3TC）+齐多夫定（AZT）的抗病毒治疗（ART）方案（aOR=1.52，95%CI：1.17~1.98）与NAFLD患病有相关性。NAFLD患病与肝功能异常呈正相关（aOR=2.01，95%CI：1.60~2.52），与肝纤维化呈负相关（aOR=0.76，95%CI：0.59~0.98）。45~59岁年龄组（aOR=7.05，95%CI：5.65~8.80）、CD4计数<200个/μl（aOR=1.45，95%CI：1.06~1.97）和使用奈韦拉平（NVP）+3TC+AZT的ART方案（aOR=1.87，95%CI：1.44~2.43）与肝纤维化呈正相关。 结论： 台州市HIV感染者的NAFLD患病率超过20.0%，伴有一定比例的肝功能异常和肝纤维化。超重及肥胖、糖尿病、血脂异常、CD4计数及特定ART方案与NAFLD患病有相关性；NAFLD患病、CD4计数与ART方案是肝功能异常和肝纤维化的主要相关因素。.