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HIV-Associated NAFLD: Disease Burden and Management

  • Fatty Liver Disease (V Ajmera, Section Editor)
  • Published:
Current Hepatology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Highly potent anti-retroviral therapy (ART) for the treatment of human immunodeficiency virus (HIV) has led to dramatic improvements in quality of life and lifespan in persons living with HIV (PLWH). PLWH, however, are suffering from other comorbid conditions, including non-alcoholic fatty liver disease (NAFLD). This review summarizes the epidemiology and pathophysiology of NAFLD in PLWH and explores unique diagnostic and treatment considerations in this population.

Recent Findings

Though it is well established that there is a high prevalence of NAFLD in PLWH, the mechanisms underlying NAFLD in this population are just beginning to be explored. Traditional NAFLD risk factors, including insulin resistance, visceral adiposity, and genetics, have been consistently linked with NAFLD in PLWH. In addition, HIV-related factors including mitochondrial dysfunction, microbiome alterations, and direct effects of the virus and of ART may play a role.

Summary

Given the burden of NAFLD in PLWH, further studies are necessary to investigate mechanisms specific to HIV with which to target therapies.

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Abbreviations

HIV:

Human immunodeficiency virus

NAFLD:

Non-alcoholic fatty liver disease

NASH:

Non-alcoholic steatohepatitis

ART:

Anti-retroviral therapy

PLWH:

Persons living with HIV

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  1. Division of Gastroenterology, Department of Medicine, Weill Cornell School of Medicine, New York Presbyterian, New York, NY, USA

    Alyson Kaplan

  2. Division of Gastroenterology, Department of Medicine, University of San Francisco California, San Francisco, CA, USA

    Jennifer C. Price

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  1. Alyson Kaplan
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Correspondence to Jennifer C. Price.

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Alyson Kaplan declares no potential conflicts of interest.

Jennifer C. Price reports grants from Gilead Sciences and Merck and ownership interest (spouse) in Abbvie, Bristol-Myers Squibb, Johnson and Johnson, and Merck, and is an advisory board member of Surrozon.

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Kaplan, A., Price, J.C. HIV-Associated NAFLD: Disease Burden and Management. Curr Hepatology Rep 18, 482–491 (2019). https://doi.org/10.1007/s11901-019-00501-0

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