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Semin Liver Dis 2012; 32(02): 103-113
DOI: 10.1055/s-0032-1316473
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Burden of Liver Disease in Human Immunodeficiency Virus-Infected Patients

Massimo Puoti
1   Department of Infectious Diseases, AO Ospedale Niguarda Ca' Granda, Milano, Italy
,
Maria Cristina Moioli
1   Department of Infectious Diseases, AO Ospedale Niguarda Ca' Granda, Milano, Italy
,
Giovanna Travi
1   Department of Infectious Diseases, AO Ospedale Niguarda Ca' Granda, Milano, Italy
,
Roberto Rossotti
1   Department of Infectious Diseases, AO Ospedale Niguarda Ca' Granda, Milano, Italy
› Institutsangaben
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Publikationsverlauf

Publikationsdatum:
03. Juli 2012 (online)

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Abstract

Introduction of effective combined antiretroviral therapy has made human immunodeficiency virus (HIV) infection a chronic illness. Substantial reductions in the number of acquired immunodeficiency syndrome- (AIDS-) related deaths have been accompanied by an increase in liver-related morbidity and mortality. Liver diseases rank in the first three most-common causes of death in HIV-infected persons. Mortality is mainly due to cirrhosis and hepatocellular carcinoma induced by hepatitis C virus and hepatitis B virus coinfection. However, antiretroviral drugs toxicity also plays a role. Nonalcoholic fatty liver disease is a common cause of liver injury as well. Nevertheless, alcohol consumption probably plays a pivotal role. Noncirrhotic portal hypertension, an uncommon condition observed in less than 1% of patients, is increasingly described. Finally, acute hepatitis A virus (HAV) and acute and even chronic hepatitis E virus infection have also been reported as causes of liver damage in HIV. Anti-HAV vaccination is thus recommended in persons at risk living with HIV.

Keywords

human immunodeficiency virus - hepatitis C virus - nonalcoholic fatty liver disease - alcoholic hepatitis - liver-related mortality - cirrhosis - noncirrhotic portal hypertension
 

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