Hepatic Disease in Patients With HIV

  • Author: Mark S. Sulkowski, MD (More Info)
  • Editors in Chief: Joseph J. Eron, Jr., MD; Daniel R. Kuritzkes, MD
  • Last Reviewed: 11/13/21 (What's New)

Summary

  • NAFLD can take several forms, including NASH, and NAFLD-associated cirrhosis, which may range from harmless to life-threatening
  • Prevalence
      Persons With HIV and HCV Coinfection
      • In persons coinfected with HIV and HCV, the prevalence of steatosis ranges from 40% to 70%, with higher rates observed among persons with significant hepatic fibrosis, HCV genotype 3, and exposure to NRTIs didanosine and stavudine[Macías 2012; Sulkowski 2005; Miller 2000; McGovern 2006; Marks 2005]
        • Since these drugs are no longer used, this risk is diminished compared with previous times. However, many older patients will undoubtedly have been exposed to these drugs in earlier regimens
      HIV-Monoinfected Patients
      Clinical Presentation and Diagnosis of Nonalcoholic Steatohepatitis
        Treatment of Nonalcoholic Fatty Liver Disease
          Pharmacologic Treatment
            Treatment of Insulin Resistance
              Treatment of Dyslipidemia
                Treatment of Hepatocyte Apoptosis

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