Crane Megan, Iser David, Lewin Sharon R
Megan Crane, Sharon R Lewin, Department of Medicine, Monash University, Melbourne 3004, Australia.
World J Hepatol. 2012 Mar 27;4(3):91-8. doi: 10.4254/wjh.v4.i3.91.
Liver disease in human immunodeficiency virus (HIV)-infected individuals encompasses the spectrum from abnormal liver function tests, liver decompensation, with and without evidence of cirrhosis on biopsy, to non-alcoholic liver disease and its more severe form, non-alcoholic steatohepatitis and hepatocellular cancer. HIV can infect multiple cells in the liver, leading to enhanced intrahepatic apoptosis, activation and fibrosis. HIV can also alter gastro-intestinal tract permeability, leading to increased levels of circulating lipopolysaccharide that may have an impact on liver function. This review focuses on recent changes in the epidemiology, pathogenesis and clinical presentation of liver disease in HIV-infected patients, in the absence of co-infection with hepatitis B virus or hepatitis C virus, with a specific focus on issues relevant to low and middle income countries.
感染人类免疫缺陷病毒（HIV）的个体所患肝病范围广泛，从肝功能检查异常、肝失代偿（活检有无肝硬化证据），到非酒精性肝病及其更严重形式，即非酒精性脂肪性肝炎和肝细胞癌。HIV可感染肝脏中的多种细胞，导致肝内凋亡、激活和纤维化增强。HIV还可改变胃肠道通透性，导致循环中脂多糖水平升高，这可能影响肝功能。本综述重点关注未合并感染乙型肝炎病毒或丙型肝炎病毒的HIV感染患者肝病的流行病学、发病机制和临床表现的近期变化，特别关注与低收入和中等收入国家相关的问题。
