Hepatic Disease in HIV-Infected Patients

  • Author: Mark S. Sulkowski, MD (More Info)
  • Editors in Chief: Daniel R. Kuritzkes, MD; Joseph J. Eron, Jr., MD
  • Last Reviewed: 9/4/18 (What's New)

Summary

  • NAFLD can take several forms, including NASH, and NAFLD-associated cirrhosis, which may range from harmless to life-threatening
    • Prevalence
      HIV/Hepatitis C Virus–Coinfected Patients
      • 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]
      • HIV-infected patients receiving ART may be at increased risk for the development of NAFLD, particularly in the setting of obesity
      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

              Action required

              Keywords: Hepatic Complications, Insulin Resistance, Special Populations

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