Expert Panel Review on Nonalcoholic Fatty Liver Disease in Persons With Human Immunodeficiency Virus

Clin Gastroenterol Hepatol. 2022 Feb;20(2):256-268. doi: 10.1016/j.cgh.2020.10.018. Epub 2020 Oct 16.

Abstract

Nonalcoholic fatty liver disease (NAFLD) affects 25% of adults in the general population and is a disease spectrum ranging from steatosis to nonalcoholic steatohepatitis (NASH) to end-stage liver disease. NAFLD is an independent risk factor for cardiovascular disease, diabetes mellitus, and all-cause mortality, and NASH cirrhosis is a frequent indication for liver transplantation. In persons with human immunodeficiency virus (PWH), chronic liver disease is the second leading cause of non-human immunodeficiency virus-related mortality. Between 20% and 63% of PWH have NASH, and 14% to 63% have NASH with fibrosis. However, little is known about the optimal diagnostic strategies, risk factors for, and treatment of NAFLD in PWH. Here, we review current data on and identify knowledge gaps in the epidemiology, pathophysiology, diagnosis, and management of NAFLD in PWH and highlight priorities for research.

Keywords: Antiretroviral Therapy (ART); Human Immunodeficiency Virus (HIV); Nonalcoholic Fatty Liver Disease (NAFLD); Nonalcoholic Steatohepatitis (NASH); Persons With HIV (PWH).

Publication types

  • Research Support, N.I.H., Intramural
  • Review

MeSH terms

  • End Stage Liver Disease* / pathology
  • HIV
  • HIV Infections* / complications
  • HIV Infections* / epidemiology
  • HIV Infections* / pathology
  • Humans
  • Liver / pathology
  • Liver Cirrhosis / epidemiology
  • Liver Cirrhosis / pathology
  • Liver Cirrhosis / therapy
  • Non-alcoholic Fatty Liver Disease* / complications
  • Non-alcoholic Fatty Liver Disease* / epidemiology
  • Non-alcoholic Fatty Liver Disease* / therapy