Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland 21287, USA.
Clin Gastroenterol Hepatol. 2010 Dec;8(12):1002-12. doi: 10.1016/j.cgh.2010.08.024. Epub 2010 Sep 17.
Since the advent of effective antiretroviral therapy (ART) for human immunodeficiency virus-1 (HIV), there has been a substantial decrease in deaths related to acquired immunodeficiency syndrome (AIDS). However, in the ART era, liver disease is now the most common non-AIDS-related cause of death among HIV-infected patients, accounting for 14%-18% of all deaths in this population and almost half of deaths among hospitalized HIV-infected patients. Just as the burden of non-AIDS morbidity and mortality has changed in the ART era, the types of liver disease the clinician is likely to encounter among these patients have changed as well. This review will discuss the causes of liver disease in the HIV-infected population in the ART era, including chronic hepatitis C virus, chronic hepatitis B virus, medication-related hepatotoxicity, alcohol abuse, nonalcoholic fatty liver disease, and AIDS-related liver diseases.
自人类免疫缺陷病毒 1(HIV)有效的抗逆转录病毒疗法(ART)问世以来,与获得性免疫缺陷综合征(AIDS)相关的死亡人数大幅下降。然而,在 ART 时代,肝脏疾病现在是 HIV 感染患者中最常见的非 AIDS 相关死亡原因,占该人群所有死亡人数的 14%-18%,几乎占住院 HIV 感染患者死亡人数的一半。就像在 ART 时代非 AIDS 发病率和死亡率的负担发生了变化一样,临床医生在这些患者中可能遇到的肝脏疾病类型也发生了变化。本文将讨论在 ART 时代 HIV 感染人群中肝脏疾病的病因,包括慢性丙型肝炎病毒、慢性乙型肝炎病毒、药物相关肝毒性、酒精滥用、非酒精性脂肪性肝病和 AIDS 相关肝病。