{"id":329,"title":"Predictors of Incident Hepatic Fibrosis and Steatotic Liver Disease-Associated Fibrosis Among Women with and without HIV","title_zh":"HIV感染女性肝纤维化发生预测因素及脂肪性肝病相关纤维化研究","url":"https://pubmed.ncbi.nlm.nih.gov/42965316","doi":"10.1093/infdis/jiag532","pmid":"42965316","journal":"J Infect Dis","kind":"paper","lang":"en","published_at":"2026-10-31T00:00:00+00:00","fetched_at":"2026-11-08T03:44:05+00:00","authors":["Duarte MJ","Tien PC","Ma Y","Kuniholm MH","Floris-Moore M","Fischl MA","French AL","Topper EF","Konkle-Parker D","Minkoff H","Ofotokun I","Plankey M","Sharma A","Price JC"],"primary_topic":"repro-aging","topics":[{"slug":"repro-tox","score":2.0,"hits":["alcohol","bmi"]},{"slug":"repro-aging","score":1.0,"hits":["reproductive aging"]}],"topic_score":2.0,"preference_score":0.0,"preference_labels":[],"llm_score":52.0,"final_score":52.0,"score_dims":{"novelty":58,"rigor":85,"impact":30,"relevance":25,"translation":25},"recommend_reason":"大样本前瞻队列设计严谨，但核心结局为HIV女性肝纤维化，与生殖医学、辅助生殖及胚胎多组学核心范畴关联弱；仅对关注HIV感染者生殖衰老期合并肝病的研究者有边缘参考价值。","keywords":["HIV感染","肝纤维化","脂肪变性","瞬时弹性成像","生殖衰老"],"selected":0,"story_id":246,"llm_provider":"deepseek","llm_model":"deepseek-flash","llm_effort":"low","source_key":"pubmed-endo-genetics","source_name":"PubMed · 生殖内分泌/遗传/保存","source_tier":1,"mention_count":1,"has_interpretation":false,"journal_key":null,"journal_tier":"unknown","journal_if":null,"is_mock":false,"summary_zh":"该研究基于WIHS/MACS-WIHS联合队列中1036名有或无HIV感染女性（2013-2020年接受至少两次振动控制瞬时弹性成像），排除病毒性肝炎、大量饮酒和基线纤维化者，分析肝纤维化（肝硬度≥7.1 kPa）发生的预测因素。平均随访3.5年，19%发生新发纤维化；HIV感染（IRR 1.72）和较高CAP值（每10 dB/m，IRR 1.04）与纤维化相关，但CAP与纤维化的关联在HIV感染者中减弱。无脂肪变性的纤维化占HIV感染者新发纤维化的28%，在既往AIDS患者中更常见。结论提示HIV感染预测肝纤维化发生，脂肪变性在HIV感染者中预测作用较弱，存在HIV特异性肝损伤通路。","summary":"BACKGROUND: Liver fibrosis is an important cause of non-AIDS morbidity among women with HIV (WWH), but predictors of incident fibrosis in the absence of viral hepatitis are not well defined. METHODS: We included women with and without HIV enrolled in the Women's Interagency HIV Study (WIHS), now part of the MACS/WIHS Combined Cohort Study, who underwent vibration-controlled transient elastography (VCTE) between 2013 and 2020 as part of the Liver Disease and Reproductive Aging (LIVRA) Study and had at least two VCTE exams. Participants with viral hepatitis, heavy alcohol use, or baseline fibrosis were excluded. Poisson regression estimated incidence rate ratios (IRRs) for incident fibrosis, defined as liver stiffness ≥7.1 kPa. Models included time-updated covariates and tested interactions between HIV and steatosis measured by controlled attenuation parameter (CAP). RESULTS: Among 1,036 women (709 WWH, 327 without HIV), median age was 49 years and median BMI 32 kg/m2. Over a mean follow-up of 3.5 years, 19% developed incident fibrosis. HIV infection (IRR 1.72, 95% CI 1.12-2.65) and higher CAP (per 10 dB/m; IRR 1.04, 95% CI 1.00-1.08) were associated with fibrosis in multivariable adjusted models. The association between CAP and fibrosis differed by HIV status (interaction p = 0.02) and was attenuated among WWH. Fibrosis without steatosis accounted for 28% of new fibrosis in WWH and was more common in those with prior AIDS. CONCLUSIONS: HIV infection predicted incident hepatic fibrosis, while steatosis was a weaker predictor in WWH. Fibrosis without steatosis was common, suggesting distinct fibrosis phenotypes and potential HIV-specific pathways of liver injury.","interpretation_basis":null,"fulltext_status":null,"interpretation":null,"fulltext":{"available":false,"status":null,"reason":"尚未抓取全文（未入选、分数未达阈值，或还没跑 fulltext 步骤）","pmcid":null,"license":null,"chars":0,"source":null,"fetched_at":null}}