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Review
. 2022 Feb;20(2):256-268.
doi: 10.1016/j.cgh.2020.10.018. Epub 2020 Oct 16.

Expert Panel Review on Nonalcoholic Fatty Liver Disease in Persons With Human Immunodeficiency Virus

Jordan E Lake  1 , Turner Overton  2 , Susanna Naggie  3 , Mark Sulkowski  4 , Rohit Loomba  5 , David E Kleiner  6 , Jennifer C Price  7 , Kara W Chew  8 , Raymond T Chung  9 , Kathleen E Corey  9
Affiliations
Review

Expert Panel Review on Nonalcoholic Fatty Liver Disease in Persons With Human Immunodeficiency Virus

Jordan E Lake et al. Clin Gastroenterol Hepatol. 2022 Feb.

Abstract

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.

Keywords: Antiretroviral Therapy (ART); Human Immunodeficiency Virus (HIV); Nonalcoholic Fatty Liver Disease (NAFLD); Nonalcoholic Steatohepatitis (NASH); Persons With HIV (PWH).

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Conflict of interest statement

Conflicts of interest

These authors disclose the following: Kathleen E. Corey has received grant support from Bristol-Myers Squibb, Novartis, and Boehringer-Ingelheim, and has consulted for Novo Nordisk, Bristol-Myers Squibb, and Gilead; and Jordan E. Lake has received research support from Gilead Sciences, CytoDyn, Pfizer, and OncoImmune, and has served as a consultant to Merck. The remaining authors disclose no conflicts.

Figures

Figure 1.
Figure 1.
Nonalcoholic fatty liver disease pathogenesis in persons with human immunodeficiency virus (HIV). HCV, hepatitis C virus; INSTI, integrase strand transfer inhibitor; NRTI, nucleoside reverse transcriptase inhibitor.
See this image and copyright information in PMC

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