a Infectious Diseases Unit, Azienda Socio Sanitaria Territoriale di MONZA, San Gerardo Hospital , University of Milano-Bicocca , Monza , Italy.
b Infectious Diseases Unit, Department of Internal Medicine, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico , University of Milan , Milan , Italy.
Expert Rev Gastroenterol Hepatol. 2019 Jul;13(7):643-650. doi: 10.1080/17474124.2019.1614913. Epub 2019 May 13.
: The burden of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) is increasing worldwide. This phenomenon poses a potentially dangerous risk of rise in mortalities caused by cirrhosis and liver cancer. Owing to a complex combination of factors, NAFLD and NASH arise in a majority of people living with HIV (PLWH), but accurate estimates of prevalence differ, depending on sample selection, type of analysis, and data interpretation. The wide range of diagnostic tools used to assess liver steatosis and lack of control groups in many studies further contributes to current difficulties in properly assessing prevalence of these conditions. : Thoroughly scrutinizing the current literature, we compared the prevalence of NAFLD and NASH in PLWH to rates found in the general population. We highlighted strengths and limitations of the studies, in order to determine the effective impact of these medical conditions in PLWH. : The prevalence and progression of NAFLD in human immunodeficiency virus (HIV) infection are reported to be widely variable. HIV infection itself and antiretroviral treatment have been demonstrated to play a role in the development of NAFLD. Larger and more effective studies are needed to evaluate the effects of NASH in PLWH and its progression.
非酒精性脂肪性肝病(NAFLD)和非酒精性脂肪性肝炎(NASH)的负担在全球范围内正在增加。这种现象可能会导致肝硬化和肝癌死亡率上升,带来潜在的危险。由于多种因素的复杂组合,大多数感染人类免疫缺陷病毒(PLWH)的人都会出现 NAFLD 和 NASH,但由于样本选择、分析类型和数据解释的不同,患病率的准确估计也有所不同。用于评估肝脂肪变性的诊断工具种类繁多,而且许多研究缺乏对照组,这进一步导致目前难以正确评估这些疾病的患病率。
我们仔细研究了目前的文献,将 PLWH 中 NAFLD 和 NASH 的患病率与普通人群中的患病率进行了比较。我们强调了这些研究的优势和局限性,以便确定这些医疗条件在 PLWH 中的实际影响。
人类免疫缺陷病毒(HIV)感染中 NAFLD 的患病率和进展情况报道差异很大。HIV 感染本身和抗逆转录病毒治疗已被证明在 NAFLD 的发展中起作用。需要更大规模、更有效的研究来评估 NASH 在 PLWH 中的影响及其进展。