Abstract: Objective To investigate the prevalence and risk factors of non-alcoholic fatty liver disease in
patients with HIV-infection after receiving highly active antiretroviral therapy (HAART). Methods HIV-
infected patients who received a government free anti-retroviral drugs and were followed-up regularly for
2 years in our hospital from 2013 to 2015 were selected. All the patients had no non-alcoholic fatty liver
disease (NAFLD) before HAART. The occurrence of NAFLD between different age, gender and HAART
were analyzed retrospectively. Liver functions, renal functions, serum glucose levels, serum fat levels, lactic
acid levels, CD4 + T cell and BMI were recorded and the relationship with NAFLD was evaluated with cross-
sectional study. Results Total of 99 HIV-infected patients were enrolled in this study and 29 (29.3%) of
them were diagnosed as NAFLD. The levels of CD4 + T cell, serum ALT, triglyceride, total cholesterol and
lactic acid had statistically significant differences between patients with or without NAFLD (P ＜ 0.05).
Single factor analysis showed that, antiretroviral regimens with TDF could reduce the incidence of NAFLD,
and gender and age were not associated with NAFLD in this study (P ＜ 0.05). Conclusions The higher
prevalence of NAFLD was found in HIV-infected patients receiving HAART in this study, which may be
associated with fat metabolic dysfunction and mitochondrial damage when receiving HAART. The CD4 + T

cell, serum ALT, triglyceride, total cholesterol and lactic acid levels in process of receiving HAART may be
related with NAFLD, which should be closely monitored in clinical work. The combined use of TDF may
reduce the incidence of NAFLD.