Liver Disease in Human Immunodeficiency Virus Infection

Oikonomou, Katerina; Tsai, Eugenia; Sarpel, Dost; Dieterich, Douglas T.

doi:10.1016/j.cld.2018.12.011

Cited by 7 publications

(4 citation statements)

References 123 publications

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“…Multiple factors may contribute to increase the risk of liver disease in the context of human immunodeficiency virus (HIV) infection, including infectious and noninfectious comorbidities, metabolic disorders, and the possible direct effects of HIV infection and antiretroviral therapy (ART). [ 1 , 2 , 3 , 4 ] In a systematic review of 10 cross‐sectional studies of primarily men living with HIV in North America, Western Europe, China, and Japan, 35% met the definition of nonalcoholic fatty liver disease (NAFLD) based on imaging or liver histology. [ 1 ] Metabolic disorders and high CD4 cell counts were associated with NAFLD, whereas duration of HIV infection, duration of ART, HIV RNA load, and nadir CD4 cell counts were not.…”

Section: Introductionmentioning

confidence: 99%

Liver steatosis and fibrosis in people with human immunodeficiency virus in West Africa and the relationship with hepatitis B virus coinfection

et al. 2022

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There is a heavy burden of liver disease in West Africa. While the role of hepatitis B virus (HBV) infection is well recognized, less is known about the contributing role of liver steatosis and how the two interact in the context of human immunodeficiency virus (HIV) infection. Adults with HIV in Ghana underwent FibroScan measurements to determine prevalence of liver steatosis (expressed as controlled attenuation parameter [CAP]) and fibrosis (expressed as liver stiffness [LS]). We explored contributing factors in linear regression models, including demographics, lifestyle characteristics, medical history, HIV and HBV status, and measurements of metabolic syndrome.Among 329 adults (72.3% women; median age, 47 years), 322 (97.9%) were on antiretroviral therapy (median duration, 8.9 years). CD4 counts were preserved (median, 619 cells/mm 3 ); plasma HIV RNA was fully suppressed in 162 (50.3%) of the treated participants. Cigarette smoking, excessive alcohol consumption, and use of traditional or herbal remedies were uncommon (6.1%, 1.8%, 3.3%, respectively). Largely undiagnosed metabolic syndrome was detected in 87 (26.4%) participants. We obtained readings indicative of

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Section: Introductionmentioning

confidence: 99%

Liver steatosis and fibrosis in people with human immunodeficiency virus in West Africa and the relationship with hepatitis B virus coinfection

et al. 2022

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“…A alteração nos analitos utilizados para prática clínica como marcadores da função hepática, pode ser resultado da injúria direta dos fármacos ou seus metabólitos sobre os hepatócitos, mas também pode ser resultado da lesão ocasionada pela ação direta do vírus HIV e ao processo inflamatório, além da combinação de todos estes fatores (Oikonomou et al, 2019;Cai et al, 2019;Lucien et al, 2010).…”

Section: Resultsunclassified

Avaliação laboratorial da função hepática em pessoas iniciando a terapia antirretroviral com esquemas contendo Dolutegravir ou Efavirenz: estudo de coorte em Belo Horizonte, Brasil

Cesar

Silveira

Maia

et al. 2022

RSD

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Objetivo: verificar qual esquema de tratamento antirretroviral foi mais seguro para pessoa que vive com HIV, dolutegravir 50mg + lamivudina 300mg + tenofovir 300mg ou efavirenz 600mg + lamivudina 300mg + tenofovir 300mg. Para isso, analisou-se os seguintes exames laboratoriais de função hepática: bilirrubina total, direta e indireta, aspartato amino transferase, alanina amino transferase, gama glutamil transferase e fosfatase alcalina. Metodologia: estudo de coorte, com o acompanhamento de 234 pessoas que vivem com HIV e iniciando terapia antirretroviral na cidade de Belo Horizonte, Minas Gerais, Brasil, com dados coletados entre agosto de 2015 a dezembro de 2018. Resultados: Os valores médios para os resultados dos exames bilirrubina total e indireta, aspartato amino transferase, alanina amino transferase e fosfatase alcalina reduziram após 72 semanas para os dois esquemas terapêuticos. A média do valor para a bilirrubina direta nas pessoas em uso de efavirenz aumentou em 72 semanas e ficou acima do valor de referência, quando comparado com a do início do acompanhamento. Para a gama glutamil transferase, a média dos resultados apresentou-se acima do valor de referência em ambos os grupos antes do tratamento. Após a terapia por 72 semanas com dolutegravir, a média retornou ao valor de referência e, no caso do efavirenz, a média manteve-se elevada. Os testes de Bonett e de Dunnett não tiveram diferença estatística, indicando que os dois esquemas terapêuticos são seguros. Conclusões: os dois esquemas terapêuticos estudados mostraram-se seguros e não ocasionaram aumento na variância para exames laboratoriais marcadores de função hepática.

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“…Elevated liver transaminases have been reported in 20-93% of PLHIV on ART [40]. PLHIV have higher prevalence of several risk factors for liver damage, such as alcohol abuse, coinfection with hepatitis B and C viruses due to shared risk factors, hepatotoxicity associated with ART, HIV itself, and metabolic dysfunction leading to non-alcoholic fatty liver disease (NAFLD) [42][43][44]. Based on alcohol-related hospital diagnoses, our study confirms that alcohol abuse is twice as common among PLHIV than among the general population and increasing during follow-up.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, the increased cumulative incidence of liver disease among PLHIV cannot be solely explained by chronic viral hepatitis. Hepatotoxicity is a common side-effect associated with ART, especially with some of the older drugs, and may be an important contributor to liver disease [42,43]. However, metabolic liver diseases have become increasingly common among PLHIV and recent studies have identified NAFLD as the most common cause of liver disease in individuals ageing with HIV mono-infection [42,47].…”

Section: Discussionmentioning

confidence: 99%

The burden of non‐communicable diseases and mortality in people living with HIV (PLHIV) in the pre‐, early‐ and late‐HAART era

Jespersen

Axelsen²,

Dollerup

et al. 2021

HIV Medicine

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To estimate the burden of non-communicable diseases (NCDs) and mortality among PLHIV in the pre-, early-and late-HAART (highly active antiretroviral therapy) era. MethodsWe conducted a cohort study using population-based Danish medical registries including all adult HIV-infected residents of the Central Denmark Region during 1985-2017. For each HIV patient, we selected 10 comparisons from the background population matched by age, sex and municipality of residence. Based on hospital-related diagnoses we estimated the prevalence and incidence of specific NCD at diagnosis and at 5 and 10 years. ResultsWe identified 1043 PLHIV and 10 430 matched comparisons. PLHIV had lower socioeconomic status and more were born outside western Europe. At HIV diagnosis, 21.9% of PHLIV vs. 18.2% of non-HIV individuals had at least one NCD, increasing to 42.2% vs. 25.9% after 10 years. PLHIV had higher prevalence and cumulative incidence of alcohol abuse, chronic obstructive pulmonary disease (COPD), ischaemic heart disease, mental disorders, renal and liver disease, but no increased risk of diabetes mellitus. Only PLHIV in the age groups 41-50 and > 51 years had an increased incidence of osteoporosis. From the pre-to the late-HAART era, 10-year mortality among PLHIV decreased from 45.5% to 9.4% but continued at more than twice that of uninfected comparisons. However, in the late-HAART era, the mortality of PLHIV who were alive 2 years after HIV diagnosis was approaching that of comparisons. ConclusionsEven in the late-HAART era, PLHIV have an excess mortality, which may be attributable to several NCDs being more prevalent among PLHIV. The prevalence rates of ischaemic heart disease, diabetes, osteoporosis and renal disease tend to increase over calendar time. Therefore, improvement of survival and quality of life of PLHIV neets strategies to reduce the risk of developing NCDs, including avoiding toxic antiretroviral therapy and lifestyle changes.

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Liver Disease in Human Immunodeficiency Virus Infection

Cited by 7 publications

References 123 publications

Liver steatosis and fibrosis in people with human immunodeficiency virus in West Africa and the relationship with hepatitis B virus coinfection

Liver steatosis and fibrosis in people with human immunodeficiency virus in West Africa and the relationship with hepatitis B virus coinfection

Avaliação laboratorial da função hepática em pessoas iniciando a terapia antirretroviral com esquemas contendo Dolutegravir ou Efavirenz: estudo de coorte em Belo Horizonte, Brasil

The burden of non‐communicable diseases and mortality in people living with HIV (PLHIV) in the pre‐, early‐ and late‐HAART era

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