Division of Infectious Disease, University of Texas Health Sciences Center at Houston, Houston, Texas.
Division of Infectious Disease, University of Alabama School of Medicine, Birmingham, Alabama.
Clin Gastroenterol Hepatol. 2022 Feb;20(2):256-268. doi: 10.1016/j.cgh.2020.10.018. Epub 2020 Oct 16.
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.
非酒精性脂肪性肝病(NAFLD)影响一般人群中 25%的成年人,是一种疾病谱,从脂肪变性到非酒精性脂肪性肝炎(NASH)到终末期肝病。NAFLD是心血管疾病、糖尿病和全因死亡率的独立危险因素,NASH 肝硬化是肝移植的常见指征。在人类免疫缺陷病毒(HIV)感染者(PWH)中,慢性肝病是与非 HIV 相关死亡的第二大主要原因。20%至 63%的 PWH 患有 NASH,14%至 63%的 PWH 患有伴有纤维化的 NASH。然而,关于 PWH 中 NAFLD 的最佳诊断策略、危险因素和治疗方法知之甚少。在这里,我们回顾了 PWH 中 NAFLD 的流行病学、病理生理学、诊断和管理方面的现有数据,并确定了知识空白,并强调了研究的重点。