Nouvelles approches pour lutter contre le fardeau de la maladie du foie gras non alcoolique dans les populations à risque

 

Giada Sebastiani

Centre universitaire de santé McGill [CUSM]

 

Domaine : nutrition et métabolisme

Programme Chercheurs-boursiers cliniciens - Junior 2

Concours 2019-2020

Liver disease is a major health problem in Canada. Fatty liver is the most frequent liver disease, affecting 25% of Canadians. Early diagnosis and identification of risk factors are essential to avoid cirrhosis and liver cancer. Fatty liver is largely unrecognized because one of the only ways to detect it is to undergo liver biopsy, which can be painful and has complications. My team has championed the new non-invasive method Fibroscan equipped with a special software for the quantification of fat in the liver. This patient-friendly test can accurately and safely diagnose fatty liver with no need for liver biopsy. This research plan targets screening for fatty liver with Fibroscan and biomarkers in populations at high risk for liver disease, including HIV+ persons and people living with diabetes. With the decline of AIDS-related mortality, liver disease is now a major contributor to mortality in HIV+ persons due to obesity, diabetes, antiretroviral medications. My data indicate that fatty liver is particularly frequent in Canadians living with HIV, affecting up to 48% of patients.

However, it is not known how fatty liver evolves to liver cirrhosis and what is the contribution of important risk factors unique to HIV, particularly antiretroviral medications. People living with diabetes are also at high risk for fatty liver and liver disease mortality. I will use Fibroscan to screen HIV+ persons and people living with diabetes for fatty liver. I will also create a cascade of care to improve the patient journey after the diagnosis of fatty liver. My research program involves collaborations between specialists in hepatology, HIV, basic science and epidemiology in a multidisciplinary research program. My ultimate aim is to improve early diagnosis, minimize the number of liver biopsies, reduce healthcare costs and to improve quality of life of Canadians at high risk for fatty liver.