***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: UNLABELLED Hepatic steatosis has been reported in human immunodeficiency virus (HIV)/hepatitis C virus ( HCV ) coinfection . However , the features of steatohepatitis , including cytologic ballooning and pericellular fibrosis , its risk factors , and the impact on disease severity in such patients are unknown . To assess this , we prospect ively review ed  liver histology in consecutive coinfected patients to define the prevalence and severity of the features of steatohepatitis , its risk factors , and its impact on the severity of liver disease . A total of 222 subjects ( 74 % male , mean age 45 , 78 % African American , 90 % genotype 1 ) were studied . The mean body mass index ( BMI ) was 26 , and 18 % had a BMI > 30 . The prevalence of risk factors for steatosis were : diabetes ( 31 % ) , hypertension ( 15 % ) , dyslipidemia ( 8 % ) , metabolic syndrome ( 9 % ) , and alcohol abuse ( 21 % ) . Steatosis was present in 23 % and steatohepatitis was present in 17 % . The steatosis was mild ( 5%-33 % ) in 19 % , and moderate to severe ( > 33 % ) in 4 % . Cytologic ballooning and pericellular fibrosis were present in 30 % and 13 % , respectively . The mean Ishak score was 6.9 , and 33 % had bridging fibrosis or cirrhosis . Both steatosis and cytologic ballooning were associated with BMI , metabolic syndrome , and insulin resistance , and presence of either was strongly associated with advanced fibrosis ( P < 0.0001 ) . By multiple logistic regressions , the following associations were identified : increased BMI , diabetes , and genotype 3 with steatosis ; diabetes with cytologic ballooning ; and longer duration of infection with steatohepatitis . CONCLUSION Steatosis and steatohepatitis are present in 23 % and 30 % , respectively , of patients with HIV/HCV coinfection , and both are associated with an increased risk of having advanced fibrosis . Although we did identify genotype 3 , increased BMI , and diabetes as risk factors , we found no independent association with antiretroviral therapy Background / Aims : Microalbuminuria is a marker for early kidney disease and cardiovascular risk . The purpose s of this study were to determine the prevalence of microalbuminuria in an HIV-infected clinic population , to test the predictive value of a single urine albumin/creatinine ratio ( ACR ) to identify persistent microalbuminuria and to examine covariates of microalbuminuria . Methods : We conducted a prospect i ve cohort study of HIV-infected subjects ( n = 182 ) without proteinuria ( urine protein/creatinine ratio ≥0.5 g/g ) , elevated serum creatinine , diabetes , or chronic inflammatory conditions . Subjects completed three research visits within 9 months . Microalbuminuria was defined as the geometric mean ACR of 25 - 355 mg/g for females and 17 - 250 mg/g for males . Results : The prevalence of microalbuminuria was 14 % . The negative predictive value of a single urine ACR determination was 98 % , whereas the positive predictive value was only 74 % . Microalbuminuria was similar among Black ( 15 % ) and non-Black ( 14 % ) subjects ( p = 0.8 ) . Subjects with microalbuminuria were more likely to have hypertension ( p = 0.02 ) and metabolic syndrome ( p = 0.03 ) . While duration of HIV infection and the level of HIV viremia were similar between groups , those with microalbuminuria were more likely to have a CD4 count < 200 cells/μl ( p = 0.0003 ) . In a multivariate logistic regression analysis , the only significant independent predictors of microalbuminuria were low CD4 count ( p = 0.018 ) and current ritonavir exposure ( p = 0.04 ) . Conclusion : The prevalence of microalbuminuria in an HIV-infected clinic population was similar to earlier reports , and was associated with hypertension and impaired immune function . A single normal ACR determination effectively excludes microalbuminuria , whereas an elevated ACR requires confirmation OBJECTIVE —The aims of this study were to determine the incidence of diabetes among HIV-infected patients in the Data Collection on Adverse Events of Anti-HIV Drugs ( D : A : D ) cohort , to identify demographic , HIV-related , and combination antiretroviral therapy (cART)-related factors associated with the onset of diabetes , and to identify possible mechanisms for any relationships found . RESEARCH DESIGN AND METHODS —D : A : D is a prospect i ve observational study of 33,389 HIV-infected patients ; diabetes is a study end point . Poisson regression models were used to assess the relation between diabetes and exposure to cART after adjusting for known risk factors for diabetes , CD4 count , lipids , and lipodystrophy . RESULTS —Over 130,151 person-years of follow-up ( PYFU ) , diabetes was diagnosed in 744 patients ( incidence rate of 5.72 per 1,000 PYFU [ 95 % CI 5.31–6.13 ] ) . The incidence of diabetes increased with cumulative exposure to cART , an association that remained significant after adjustment for potential risk factors for diabetes . The strongest relationship with diabetes was exposure to stavudine ; exposures to zidovudine and didanosine were also associated with an increased risk of diabetes . Time-up date d measurements of total cholesterol , HDL cholesterol , and triglycerides were all associated with diabetes . Adjusting for each of these variables separately reduced the relationship between cART and diabetes slightly . Although lipodystrophy was significantly associated with diabetes , adjustment for this did not modify the relationship between cART and diabetes . CONCLUSION —Stavudine and zidovudine are significantly associated with diabetes after adjustment for risk factors for diabetes and lipids . Adjustment for lipodystrophy did not modify the relationship , suggesting that the two thymidine analogs probably directly contribute to insulin resistance , potentially through mitochondrial toxicity OBJECTIVE In the course of performing systematic review s on the prevalence of low back and neck pain , we required a tool to assess the risk of study bias . Our objectives were to ( 1 ) modify an existing checklist and ( 2 ) test the final tool for interrater agreement . STUDY DESIGN AND SETTING The final tool consists of 10 items addressing four domains of bias plus a summary risk of bias assessment . Two research ers tested the interrater agreement of the tool by independently assessing 54 r and omly selected studies .  Interrater agreement overall and for each individual item was assessed using the proportion of agreement and Kappa statistic . RESULTS Raters found the tool easy to use , and there was high interrater agreement : overall agreement was 91 % and the Kappa statistic was 0.82 ( 95 % confidence interval : 0.76 , 0.86 ) . Agreement was almost perfect for the individual items on the tool and moderate for the summary assessment . CONCLUSION We have addressed a research gap by modifying and testing a tool to assess risk of study bias . Further research may be useful for assessing the applicability of the tool across different conditions 
    Output:
    
Conclusions The similar range of MS prevalence in the HIV-infected and general population s highlights the common drivers of this condition .
Management strategies recommended for MS in the general population will likely provide similar benefits in the HIV-infected