HIV positive men with Non‐Alcoholic Steatohepatitis (NASH) have altered hepatic fatty acid composition

Hepatic fatty acid (FA) composition might play a role in the development of simple hepatic steatosis (SS) to NASH. Aim was to compare hepatic FA composition in HIV+ men with NASH to those with SS. METHOD: Prospective, cross‐sectional study in 19 HIV+ men (6 SS, 13 NASH). Hepatic FA composition (% of total lipid, gas chromatography) and lipid peroxidation (LPO, testkit), blood biochemistry, anthropometry, medical history and dietary intake were assessed. Mann‐Whitney‐U test was used, p<0.05 is considered significant. RESULTS: HIV‐NASH had lower arachidonic acid (AA) (mean±SEM: 1.4±0.4 vs. 3.0±0.5%) and docosahexaenoic acid (DHA) (0.37±0.86 vs. 0.86±0.10%) compared to HIV‐SS. Metabolite/precursor ratio was significantly reduced for n‐6 PUFA (AA/linoleic acid: 0.24±0.04 vs. 0.45±0.12) and a trend was seen for n‐3 ((eicosapentaenoic acid +DHA)/linolenic acid: 1.4±0.3 vs. 3.0±0.7; p=0.062). HIV‐NASH were older (47±2 vs. 40±2 y), but LPO, body mass index, diet and other variables were not different. Similar results were found when HIV‐NASH were compared to healthy controls. In addition, n6/n3 ratio was increased (HIV‐NASH: 9.1±1.4 vs. controls: 5.4±0.5). CONCLUSION: HIV+ men with NASH have reduced long‐chain PUFA and metabolite/precursor ratios in hepatic total lipids, suggesting changes in FA metabolism. Other factors do not seem to play a role. Funded by Ontario HIV Treatment Network.