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NASH in HIV.

Adriana Cervo1,2, Mohamed Shengir3, Keyur Patel4

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|September 28, 2020
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Summary
This summary is machine-generated.

People with HIV (PWH) face increased risks of nonalcoholic steatohepatitis (NASH) and liver fibrosis due to aging comorbidities and treatments. Early detection and intervention are crucial for managing this emerging liver condition in PWH.

Keywords:
Antiretroviral therapyInterventionsLiver fibrosisMetabolic comorbiditiesNon-invasive diagnostic testsNonalcoholic steatohepatitis

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Area of Science:

  • Hepatology
  • Infectious Diseases
  • Geriatrics

Background:

  • Aging-related comorbidities, particularly liver disease, are significant drivers of morbidity and mortality in people with HIV (PWH).
  • Nonalcoholic fatty liver disease (NAFLD) is increasingly recognized as a common comorbidity in aging PWH.
  • NAFLD can progress to nonalcoholic steatohepatitis (NASH), characterized by inflammation, injury, fibrosis, and potentially cirrhosis.

Purpose of the Study:

  • To review the current knowledge on nonalcoholic steatohepatitis (NASH) as an emerging comorbidity in people with HIV (PWH).
  • To highlight the increased risk of NASH and liver fibrosis in PWH.
  • To discuss the potential pathogenic mechanisms and clinical management strategies for NASH in PWH.

Main Methods:

  • Review of recent studies and clinical data on NASH in PWH.
  • Discussion of hypothesized pathogenic mechanisms.
  • Evaluation of non-invasive diagnostic tests for NASH-related fibrosis.

Main Results:

  • PWH exhibit a higher risk for NASH and NASH-related liver fibrosis.
  • Potential contributing factors include metabolic comorbidities, antiretroviral therapy, and chronic HIV infection.
  • Non-invasive tests like serum biomarkers and elastography aid in identifying fibrosis and guiding management.

Conclusions:

  • Clinicians must be aware of the prevalence and significance of NASH in PWH.
  • Early identification and intervention, including lifestyle changes and pharmacotherapy, are essential.
  • Improved risk stratification and clinical management are necessary for this growing population.