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Liver abnormalities in the immunosuppressed

Michelle C M Cheung1, Kosh Agarwal

  • 1Institute of Liver Studies, King's College Hospital Foundation Trust, King's Health Partners, Denmark Hill, London SE5 9RS, United Kingdom.

Best Practice & Research. Clinical Gastroenterology
|October 5, 2013
PubMed

The immunosuppressed state may arise due to medical illness or drug therapy, which can result in a diverse array of liver derangements. This article discusses the commonly-encountered immunosuppressed conditions and the associated specific liver diseases. Due to the frequency of blood-borne viral disease globally, viral hepatitis (hepatitis B and C) during chemotherapy, transplantation and the increasingly utilised biological therapies for autoimmune disorders is discussed. An overview of human immunodeficiency virus co-infection with hepatitis B and C is provided. This article aims to highlight the variety of liver diseases which can occur in clinically relevant, particularly iatrogenic, immunosuppressed conditions, and summarise learning and practice points for clinicians. Recognition and prevention of viral liver disease is crucial and early involvement of experts prior to administration of immunosuppressive therapy is advised.

Keywords:
Coinfection/drug therapyGraft-versus-host diseaseHIV infections/drug therapyHIV infections/virologyHaematopoietic stem cell transplantationHepatitis B, chronic/drug therapyHepatitis B, chronic/epidemiologyHepatitis B, chronic/prevention & controlHepatitis C, chronic/drug therapyHepatitis C, chronic/epidemiologyImmunosuppressionInterferons/therapeutic useKidney diseases/virologyLiver/pathology

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