Eight‐year changes in hepatic steatosis and associated metabolic factors in a Japanese cohort of people with HIV

Abstract Objectives Hepatic steatosis is an increasingly important liver‐related comorbidity among people with HIV. We evaluated longitudinal changes in hepatic steatosis over 8 years and the associated clinical factors in a single‐centre Japanese cohort of people with HIV. Methods This single‐centre retrospective cohort study included 94 people with HIV who underwent paired FibroScan assessments a median of 8.18 years apart. Hepatic steatosis was defined as a controlled attenuation parameter (CAP) ≥238 dB/m, with incident steatosis defined as CAP Results Median CAP increased from 232 to 282 dB/m ( p  p  = 0.001). Of 49 participants without baseline steatosis, 24 (49%) developed incident steatosis. After adjustment for baseline CAP, greater percentage weight gain, higher baseline body mass index and triglycerides ≥200 mg/dL at follow‐up were each associated with higher follow‐up CAP, whereas tenofovir alafenamide (TAF) exposure during follow‐up was not. Median liver stiffness measurement (LSM) did not change significantly. Conclusions CAP values and the prevalence of hepatic steatosis increased over 8 years in this single‐centre Japanese cohort of people with HIV. Greater weight gain and metabolic abnormalities were associated with higher CAP at follow‐up. These observational findings suggest that monitoring body weight, metabolic parameters, hepatic steatosis and liver stiffness may be useful in long‐term HIV care.