Hepatic steatosis is common in persons with HIV and hepatitis C virus (HCV); yet biopsy measurement of steatosis is prone to sampling error. We compared magnetic resonance spectroscopy (MRS) measurement of steatosis to histology in HIV/HCV-coinfected patients, and explored the associated adipose tissue and metabolic factors.
Cross-sectional analysis of 42 HIV/HCV-coinfected men and women. Logistic regression analysis identified factors [MRI-measured visceral adipose tissue (VAT) and abdominal subcutaneous adipose tissue (SAT) and Homeostasis Model Assessment (HOMA) estimated insulin resistance] associated with histologic steatosis (≥5% of hepatocytes with fat) and MRS steatosis (≥5% of hepatic fat).
MRS steatosis was strongly associated with histologic steatosis, when measured continuously [odds ratio: 10.2 per doubling of MRS-measured hepatic fat; 95% confidence interval (CI):2.9, 69.3] and dichotomously (Kappa coefficient=0.52; p=0.0007). Four of the 10 with MRS-measured steatosis did not have histologic steatosis; 3 of 9 with histologic steatosis did not have MRS-measured steatosis (67% sensitivity; 88% specificity). Associations of VAT and abdominal SAT were associated with both histologic and MRS-measured steatosis. Insulin resistance was also associated with both.
When compared to histology, MRS was similarly associated with adipose tissue and metabolic factors. MRS is a useful non-invasive alternative to biopsy in HIV/HCV coinfection.
Keywords: Steatosis, Magnetic Resonance Spectroscopy, HIV, HCV, Adipose tissue, Insulin Resistance