Author information
1Jennifer C. Price, MD, PhD, is a Professor, Division of Gastroenterology and Hepatology, University of California San Francisco, San Francisco, California, USA. Kyoko Hirose, BA, is a Research Coordinator, Division of Gastroenterology and Hepatology, University of California San Francisco, San Francisco, California, USA. Naga Chalasani, MD, is a Professor, Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA. Holly Crandall, RN, BSN, CCRP, is a Project Manager, Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA. Sonya Heath, MD, is a Professor, Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA. Rohit Loomba, MD MHSc, is a Professor, Division of Gastroenterology and Hepatology, University of California, San Diego, California, USA. Susanna Naggie, MD, is a Professor, Duke Clinical Research Institute, Duke University, Durham, North Carolina, USA. Richard K. Sterling, MD, MSc, is a Professor, Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University, Richmond, Virginia, USA. Mark Sulkowski, MD, is a Professor, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. Laura Wilson, ScM, is a Senior Research Associate, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA. Jordan E. Lake, MD, MSc, is an Associate Professor, Division of Infectious Disease, University of Texas Health Sciences Center at Houston, Houston, Texas, USA.
Abstract
Nonalcoholic fatty liver disease (NAFLD) is highly prevalent in people with HIV (PWH) and increases the risk of hepatic fibrosis and hepatocellular carcinoma. We sent an online survey to providers of the American Academy of HIV Medicine. Of respondents (n = 214, 8% response rate), 65% reported screening for NAFLD in PWH, with 28% routinely screening all patients. Most respondents refer patients to hepatology if workup suggests another coexisting liver disease or cirrhosis, with the primary goals of referral being additional diagnostic testing (60%) or specific treatments (75%). The most common barriers to screening were feeling unsure of what tests to order (28%) and how to conclusively diagnose NAFLD (29%). Most respondents were interested in society guidelines (73%) and NAFLD education for patients (57%) and providers (55%). Our findings support the development of NAFLD clinical practice guidelines for HIV providers and the inclusion of PWH in clinical trials of novel agents.