Human Immunodeficiency Virus Infection, Antiretroviral Therapy, and Liver Pathology

Gastroenterol Clin North Am. 2017 Jun;46(2):327-343. doi: 10.1016/j.gtc.2017.01.007.

Abstract

The improvement in antiretroviral therapy has significantly impacted the lives of people living with human immunodeficiency virus (HIV). In high-income countries, HIV deaths are predominated by liver disease consequent to viral hepatitis coinfection, alcohol, and nonalcoholic fatty liver disease. Published liver pathology findings have shifted from being predominated by opportunistic infections to the metabolic effects of HIV and antiretroviral therapy as well as drug-induced liver injuries. Differences remain between high-income and low-income countries, where opportunistic infections and immune reconstitution syndromes, dominate findings.

Keywords: Coinfections; Drug-induced liver injury; HIV; Low/high-income countries; Obesity.

Publication types

  • Review

MeSH terms

  • Anti-Retroviral Agents / adverse effects
  • Anti-Retroviral Agents / therapeutic use*
  • Biopsy
  • Chemical and Drug Induced Liver Injury / diagnosis
  • Chemical and Drug Induced Liver Injury / etiology
  • Chemical and Drug Induced Liver Injury / pathology*
  • Coinfection / complications
  • Coinfection / drug therapy
  • Coinfection / pathology
  • HIV Infections / complications
  • HIV Infections / drug therapy*
  • HIV Infections / pathology*
  • Hepatitis B, Chronic / complications
  • Hepatitis B, Chronic / pathology
  • Hepatitis C, Chronic / complications
  • Hepatitis C, Chronic / pathology
  • Humans
  • Immune Reconstitution Inflammatory Syndrome / microbiology
  • Integrase Inhibitors / adverse effects
  • Liver / pathology*
  • Protease Inhibitors / adverse effects
  • Reverse Transcriptase Inhibitors / adverse effects
  • Reverse Transcriptase Inhibitors / therapeutic use*

Substances

  • Anti-Retroviral Agents
  • Integrase Inhibitors
  • Protease Inhibitors
  • Reverse Transcriptase Inhibitors