Prevalence and Correlates of Steatotic Liver Disease among People with HIV in Uganda

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ID: 315203
2026
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Abstract
Abstract Introduction Liver disease is an important cause of morbidity and mortality among people with HIV (PWH). Steatotic liver disease (SLD) is a leading cause of liver disease among PWH in the global North. However, there is a dearth of data on the epidemiology of SLD in sub-Saharan Africa. Methods We analyzed computed tomography (CT) images from a completed cohort study comprised of ambulatory people with and without HIV. We defined SLD as one or more of the following: 1) mean liver attenuation (density) of < 40 Hounsfield Units (HU); 2) mean liver:mean spleen attenuation ratio <1; or 3) a difference of <1 HU between the mean attenuation values of the liver and spleen. We fit multivariable regression models to evaluate the association of HIV with SLD. In a sub-analysis to explore HIV-specific effects, we excluded those who reported high-risk alcohol consumption. Results A total of 579 had interpretable liver images. Prevalence of SLD was low overall (22/579, 3.8%), and higher among PWH compared with PWoH (5.4% vs. 2.3%, p=0.056). In multivariable regression models, PWH on ART were more likely to have SLD (AOR 2.79, 95%CI [1.10, 7.09], p=0.031), even after exclusion of people with high-risk alcohol consumption (AOR 2.96, 95%CI [1.00, 8.70], p=0.048). Conclusion We found a low overall prevalence of SLD in Uganda, but that older-age PWH on ART had a higher prevalence of SLD than those without HIV. Variation in the prevalence of SLD in the African region may be due to the variability in the methods used.
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Authors Prossy Bibangambah, Moses Acan, Brian Ghoshhajra, Geoffrey Erem, Rita Nassanga, Andrew Ochieng, Vikas Thondapu, M Lu, Mangun Randhawa, Angelo Takigami, Zahra Reynolds, F Atwiine, Edna Tindimwebwa, Rebecca F. Gilbert, Susanne S Hoepner, Eliza Passell, Shruti Sagar, Yao Tong, Ntobeko A B Ntusi, Judy Hahn, T A Gaziano, C T Longenecker, A Tsai, Jennifer Manne‐Goehler, S Asiimwe, Samson Okello, M Siedner
Journal Open forum infectious diseases
Year 2026
DOI
10.1093/ofid/ofag325
URL
https://doi.org/10.1093/ofid/ofag325
Keywords Keywords not found

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