Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Jun 27, 2022; 14(6): 1173-1181
Published online Jun 27, 2022. doi: 10.4254/wjh.v14.i6.1173
Relationship between phase angle, steatosis, and liver fibrosis in patients coinfected with human immunodeficiency virus/hepatitis C virus
Sabrina Alves Fernandes, Cristiane Valle Tovo, André Luiz Machado da Silva, Letícia Pereira Pinto, Randhall B Carteri, Angelo A Mattos
Sabrina Alves Fernandes, Cristiane Valle Tovo, Letícia Pereira Pinto, Angelo A Mattos, Postgraduate Program in Hepatology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre 90050-170, Brazil
André Luiz Machado da Silva, Department of Infectology Service, Hospital Nossa Senhora da Conceição, Porto Alegre 91350-200, Brazil
Randhall B Carteri, Department of Nutrition, Centro Universitário Metodista-IPA, Porto Alegre 90420-060, Brazil
Randhall B Carteri, Department of Nutrition, Centro Universitário CESUCA, Cachoeirinha 94935-630, Brazil
Author contributions: Fernandes SA was responsible for the conception and design, data collection, statistical analysis, and manuscript writing; Tovo CV was responsible for the conception and design, statistical analysis, manuscript writing, and critical revision; da Silva ALM was responsible for data collection, manuscript writing, and critical revision; Pinto LP was responsible for data collection, statistical analysis, and critical revision; Carteri RB was responsible for the statistical analysis, manuscript writing, and critical revision; Mattos AA was responsible for conception and design, statistical analysis, manuscript writing, and critical revision.
Institutional review board statement: This project was approved by the Research Ethics Committee, No. 2.387.800.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data is available for sharing.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Cristiane Valle Tovo, PhD, Research Assistant Professor, Research Associate, Research Scientist, Postgraduate Program in Hepatology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Rua Sarmento Leite 245, Porto Alegre 90050-170, Brazil. cristianev@ufcspa.edu.br
Received: December 12, 2021
Peer-review started: December 12, 2021
First decision: March 24, 2022
Revised: April 16, 2022
Accepted: May 28, 2022
Article in press: May 28, 2022
Published online: June 27, 2022
Processing time: 192 Days and 17.4 Hours
Abstract
BACKGROUND

Malnutrition, lipodystrophy, and dyslipidemia are prevalent characteristics in patients with human immunodeficiency virus (HIV) infection with or without previous treatment. Such a clinical condition can lead to the hypothesis of the presence of hepatic steatosis with possible progression to fibrosis and the risk of hepatocellular carcinoma. Notably, a low phase angle (PA), evaluated by bioelectrical impedance analysis (BIA), is an independent prognostic marker of clinical progression and survival in HIV-infected patients.

AIM

To evaluate the relationship between PA and body composition with steatosis and hepatic fibrosis in HIV/hepatitis C virus (HCV)-coinfected patients.

METHODS

A retrospective observational study by convenience sampling of coinfected HIV/HCV patients, in which all patients underwent transient elastography (Fibroscan) and BIA evaluation. Student’s t test was used for group comparisons, and Spearman’s or Pearson’s correlation test was used when appropriate. The significance level was set at 5%, and analyses were performed using SPSS version 21.0.

RESULTS

Forty-three patients who received antiretroviral therapy met the inclusion criteria, and 23 (53.5%) were under treatment with protease inhibitors (PIs). There was no difference in PA between those who used PIs and those who did not (P = 0.635). There was no correlation between fibrosis grade and PA (P = 0.355) or lean mass (P = 0.378). There was a significant inverse correlation between the controlled attenuation parameter (CAP) and lean mass (P = 0.378), positive correlation between PA and lean mass (P = 0.378), and negative correlation between PA and fatty mass (P = 0.378), although the CAP and PA were not correlated. When evaluated by sex, no significant correlations were found.

CONCLUSION

PA determines the muscle function of HIV/HCV-coinfected patients, and the CAP values reinforce the association with lean mass, suggesting that patients require early nutritional interventions.

Keywords: Phase angle; Bioelectrical impedance; Coinfection; Human immunodeficiency virus; Hepatitis C virus; Nutrition

Core tip: Patients living with human immunodeficiency virus (HIV) are often affected by malnutrition, which may be related to the progression of liver disease. A low phase angle (PA), assessed by bioelectrical impedance analysis, is a prognostic marker of clinical progression and survival in HIV-infected patients. This study aimed to assess the relationship between PA, steatosis, and liver fibrosis in HIV/hepatitis C virus (HCV)-coinfected patients. Forty-three HIV/HCV-coinfected patients were included in this study. PA determines the muscle functionality of patients coinfected with HIV/HCV, and the controlled attenuation parameter values reinforce the association with lean mass, suggesting that patients require early nutritional interventions.