Question
Is being HIV positive why I have hepatic steatosis?
10 January 2024. Related: All topics, Changing treatment, Living with HIV long-term, Research, Side effects.
Hi there. I’m male, 164 cm height, 83 kg weight.
I know that I’m overweight.
I started HIV treatment about 2 month ago. I’m using TLD.
I checked my liver using ultrasonography. The result is hepatosteatoz (hepatic steatosis) (grade B).
Now I would like to know, if this diease is related to HIV or TLD or being overweight?
Should I ask my doctor to change my treatment? If yes, which drugs are recomended?
Answer
Hi, how are you doing?
No. This is not related to HIV. There was some thought of association and it is more prevalent in HIV positive men. However the difference is too small and not considered clinically significant.
The most common risk factor for hepatic steatosis is being overweight which you have stated that you are.
TLD can contribute to this but is not a direct cause. TLD has been seen to cause weight gain in the first few years after starting treatment. TLD can increase appetite leading to an indirect cause of weight gain. This often settles after 2 years and is a manageable side effect.
If you have noticed that you are not currently gaining weight, there would be no benefit from switching away from TLD.
Josh.
Hi Aykhan, no you should not stop HIV treatment. It can be common for ALT changes to be seen while taking TLD however these have not been seen to be clinically relevant – no symptoms are caused by this raise in ALT.
There is no risk in continuing treatment. This can be managed with regular monitoring of your liver function. If your ALT raises above x5 the normal limit, this is when discussions can be had with your doctor about switching treatment and finding a better alternative.
Hi Josh, thank you for answering. By the way I also have enlarged liver (162 mm) and hepatic steatosis(fatty liver). My blood test results abnormal, my ALT is high.
Should I stop HIV drugs?