Study gives clues on how to stop HIV reemergence
The study appears in the February 1, 2020 issue of the journal AIDS .
Dr. Sebastiani notes that NAFLD currently affects up to 48% of Canadians living with HIV and 25% of the general population, while NASH affects about one third of patients with NAFLD. There are several theories to explain the high prevalence of fatty liver among HIV-positive patients, explains Dr. Sebastiani: "It is possibly due to HIV-related inflammation, the antiretroviral drugs that they have to take lifelong, and to very frequent metabolic problems, such as diabetes and high lipids. Unfortunately, there is no approved therapy for fatty liver in people living with HIV."
In the study, 27 patients with HIV and NASH were given vitamin E in an easily-tolerated dose of two pills per day. "We found that vitamin E improved both liver transaminases (the main blood tests for liver function) and liver fat measured by a non-invasive ultrasonographic test," says Dr. Sebastiani. "These improvements were even more marked than those reported in the HIV-uninfected population." Although she suspected vitamin E would reduce inflammation and fat in the HIV-positive group, Dr. Sebastiani was pleasantly surprised by the size of the effect.
Dr. Sebastiani notes that because the study did not have the benefit of a control group, and the study group was small and had a short follow-up (24 weeks), it's considered a pilot project. "We would be interested in conducting a larger randomized controlled trial, with a longer follow-up," she says.
Dr. Sebastiani came to McGill seven years ago from Italy with the goal of establishing a world-class research program focused on fatty liver and non-invasive diagnostic tools for liver disease. In the intervening years, cases of fatty liver disease, which was previously associated only with alcohol abuse, have exploded, particularly among obese Canadians. Dr. Sebastiani predicts that NAFLD will become the leading cause of liver transplants in the next 10 years. Source:
McGill University Journal reference:
Sebastiani, G., et al. (2020) Vitamin E is an effective treatment for nonalcoholic steatohepatitis in HIV mono-infected patients. AIDS . doi.org/10.1097/QAD. 2412 .
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