Related Experiment Video

Updated: Jul 13, 2026

New Thrombectomy Technique for Total Portal Vein Thrombosis in Liver Transplantation
08:45

New Thrombectomy Technique for Total Portal Vein Thrombosis in Liver Transplantation

Published on: June 27, 2025

Diagnosis and management of cirrhosis in coinfected patients

Maurizio Bonacini1

  • 1Department of Medicine, University of California at San Francisco, School of Medicine, USA. BonaciM@sutterhealth.org

Journal of Acquired Immune Deficiency Syndromes (1999)
|August 30, 2007
PubMed

Insights

HIV coinfection accelerates liver disease progression, increasing mortality. While antiretroviral therapy helps, drug-induced liver injury is a risk, necessitating careful management and early liver transplant evaluation for coinfected patients.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Immunology

Background:

  • Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections cause liver disease, which progresses faster in patients coinfected with human immunodeficiency virus (HIV).
  • Liver complications are a significant cause of morbidity and mortality in HIV-HBV/HCV coinfected individuals.
  • Highly active antiretroviral therapy (HAART) can slow HIV progression but carries a risk of drug-induced liver injury (DILI), particularly in coinfected patients.

Purpose of the Study:

  • To review the impact of HIV coinfection on liver disease progression and management.
  • To highlight the challenges and considerations for managing liver disease complications in coinfected patients.
  • To emphasize the importance of liver transplantation in advanced HIV-related liver disease.

Main Methods:

  • Literature review of studies on HIV and HBV/HCV coinfection.
  • Analysis of disease progression, complications, and treatment outcomes.
  • Synthesis of current clinical guidelines and recommendations.

Main Results:

  • HIV coinfection accelerates liver fibrosis and cirrhosis development in HBV/HCV patients.
  • DILI from antiretroviral drugs is more prevalent in coinfected individuals.
  • Cirrhosis in coinfected patients leads to poorer survival and increased risk of complications like ascites, variceal bleeding, and hepatocellular carcinoma.
  • Liver transplantation is a viable option for coinfected patients, with early evaluation being critical due to accelerated disease.

Conclusions:

  • HIV coinfection significantly worsens liver disease outcomes in HBV/HCV patients.
  • Management of cirrhosis and its complications should be consistent across coinfected and monoinfected patients.
  • Early consideration for liver transplantation is crucial for improving survival in coinfected individuals with advanced liver disease.

Related Concept Videos

Cirrhosis I: Introduction01:23

Cirrhosis I: Introduction

Cirrhosis is a chronic, irreversible liver disease characterized by the widespread replacement of healthy liver tissue with fibrotic scar tissue and the formation of regenerative nodules.Etiology of cirrhosisCirrhosis results from sustained liver injury that triggers progressive fibrosis and structural remodeling. The underlying causes are diverse, encompassing common and less frequent clinical conditions. Regardless of the origin, all causes lead to chronic inflammation, hepatocyte loss, and...
Cirrhosis II: Pathophysiology01:24

Cirrhosis II: Pathophysiology

Cirrhosis is a progressive chronic liver injury caused by prolonged inflammation, excessive fibrotic remodeling, and impaired regeneration. Over time, repeated hepatic insults disrupt the liver’s architecture and function, leading to reduced blood flow, impaired bile drainage, and diminished metabolic capacity.Pathophysiology of cirrhosisCirrhosis arises from three main responses to chronic liver damage: inflammation, immune activation, and hepatocyte death. These processes lead to structural...
Esophageal Varices-II: Clinical Features and Management01:28

Esophageal Varices-II: Clinical Features and Management

Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol abuse, or...
Pleural Effusion II: Symptoms and Management01:28

Pleural Effusion II: Symptoms and Management

Pleural Effusion Overview
A pleural effusion is the abnormal collection of fluid between the parietal and visceral pleura layers of tissue that form the lining of the lungs and chest cavity. It can occur independently or due to surrounding parenchymal diseases, such as infection, malignancy, or inflammatory conditions.
Clinical Manifestations:
Diseases of the Liver and Gallbladder01:26

Diseases of the Liver and Gallbladder

Liver and gallbladder diseases are a significant health concern, with prominent conditions including cirrhosis, hepatitis, non-alcoholic fatty liver disease (NAFLD), and gallstones. Jaundice is a common manifestation of liver and biliary disease.
Cirrhosis is characterized by the scarring of hepatic lobules in the liver, which are replaced by fibrous tissue, affecting the liver's normal functioning. NAFLD, on the other hand, is caused by an excessive build-up of fat in the liver, not related to...
Chronic Pancreatitis II: Collaborative Care01:29

Chronic Pancreatitis II: Collaborative Care

The management of chronic pancreatitis is multifaceted, involving a comprehensive approach that includes thorough assessment, diagnostic testing, and a variety of management strategies.
Assessment: