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People with HIV are at risk for liver fibrosis and steatosis
Liz Highleyman, 2017-08-21 11:10:00

Metabolic syndrome, type 2 diabetes and obesity are risk factors for the development of liver fibrosis and steatosis (liver fat accumulation) in people living with HIV, including those who do not have viral hepatitis co-infection, according to research presented at the 9th International AIDS Society Conference on HIV Science (IAS 2017) last month in Paris.

As effective antiretroviral therapy (ART) has reduced deaths from opportunistic infections, liver disease has become a major cause of morbidity and mortality among people living with HIV. Hepatitis B or C, heavy alcohol consumption and other causes of liver injury can lead to the development of fibrosis and steatosis, but these may also occur without such liver-specific risk factors.

Fibrosis occurs when scar tissue replaces normal hepatocytes, the cells that carry out the liver's viral functions. Cirrhosis is the most advanced stage of fibrosis (stage F4). Steatosis occurs when hepatocytes fill up with fat. Non-alcoholic fatty liver disease (NAFLD) develops in people who do not drink heavily; non-alcoholic steatohepatitis (NASH) is its more advanced stage. Over time, these progressive conditions can lead to liver function impairment, liver cancer and the need for a liver transplant.

A recently published systematic review found that at least one in five people living with HIV who do not have co-infection with hepatitis B or C had NASH. Metabolic syndrome, hypertension and high body mass index were found to be significant risk factors for NAFLD in people living with HIV.