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J Acquir Immune Defic Syndr. 2010 Oct;55(2):228-31. doi: 10.1097/QAI.0b013e3181e1d963.

Adipose tissue and metabolic factors associated with steatosis in HIV/HCV coinfection: histology versus magnetic resonance spectroscopy.

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  • 1Department of Medicine, California Pacific Medical Center, San Francisco, CA, USA.



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 and abdominal subcutaneous adipose tissue and Homeostasis Model Assessment-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: 2.9 to 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 visceral adipose tissue and abdominal subcutaneous adipose tissue were associated with both histologic and MRS-measured steatosis. Insulin resistance was also associated with both.


When compared with histology, MRS was similarly associated with adipose tissue and metabolic factors. MRS is a useful noninvasive alternative to biopsy in HIV/HCV coinfection.

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