艾滋病毒感染妇女的肝病
Andrea R Amaro1, Hayk Darbinyan2, Ani Kardashian1
1Division of Gastrointestinal and Liver Diseases, Department of Medicine, University of Southern California, Los Angeles.
Current opinion in HIV and AIDS
|November 4, 2025
概括
艾滋病毒感染女性 (WWH) 面临着独特的肝病挑战. 与代谢功能障碍相关的脂肪性肝病 (MASLD) 和与酒精有关的肝病越来越普遍,需要有针对性的干预措施.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 传染性疾病 传染性疾病
- 内分泌学 在内分泌学.
背景情况:
- 慢性肝病是艾滋病毒感染妇女的主要非艾滋病毒死亡原因.
- 抗逆转录病毒疗法 (ART) 将疾病患病率从病毒性肝炎转移到与酒精有关的肝病和与代谢功能障碍相关的脂肪性肝病 (MASLD).
- 世界卫生组织面临独特的风险,包括社会边缘化,生物性别差异和影响肝脏健康的艾滋病毒感染.
研究的目的:
- 审查WWH中肝损伤的病理生理学,自然史和管理.
- 探索病毒,药理和性激素相关因素在肝病进展中的作用.
- 确定挑战和未来的研究需求,以改善WWH中的肝脏健康.
主要方法:
- 在WWH中对病理生理学,自然史和肝脏疾病管理的文献综述.
- 分析导致纤维生成加速和肝脏肥胖症的因素.
- 检查更年期过渡和与艾滋病毒相关的雌激素缺乏症的影响.
主要成果:
- MASLD和与酒精有关的肝病现在比病毒性肝炎相关的肝病在WWH中更为普遍.
- 在WWH中加速纤维化包括HIV,ART,肠道屏障受损和微生物组变化.
- 更年期过渡加剧了由于雌激素缺乏而导致的WWH中的益菌原性状态;GLP-1激动剂对MASLD有希望.
结论:
- 在肝病治疗方面,WWH面临着明显的障碍,这些障碍受到社会,生物学和艾滋病毒特异性因素的影响.
- 进一步的研究至关重要,以了解机理,并制定干预措施,以改善WWH中的肝脏健康结果.
- 解决社会边缘化和生物学性别差异问题是改善对这一群体的护理的关键.
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