Skip Navigation LinksHome > July 2011 - Volume 6 - Issue 4 > Influence of antiretroviral therapy on liver disease
Current Opinion in HIV & AIDS:
doi: 10.1097/COH.0b013e3283473405
Cohort analysis of clinical and treatment outcomes: Edited by Carolyn Williams, Matthew Law and Francois Dabis

Influence of antiretroviral therapy on liver disease

Kovari, Helen; Weber, Rainer

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Abstract

Purpose of review: Liver disease is a major cause of morbidity and mortality in HIV-infected persons. The long-term beneficial versus potentially harmful influence of antiretroviral therapy (ART) on the liver is debated. We review current data on factors contributing to liver disease in HIV-monoinfected as well as in HIV/viral hepatitis-coinfected patients, highlighting the role of ART, HIV itself, immunodeficiency, patient characteristics, and lifestyle risk factors.

Recent findings: New ART-related clinical syndromes, including noncirrhotic portal hypertension and nonalcoholic fatty liver disease, have emerged, and observational data suggest long-term ART-associated liver injury. Recently, there is increasing evidence that HIV itself and immunosuppression are contributing to liver injury in both HIV-coinfected and HIV-monoinfected patients. In HIV-positive persons, ART attenuates progression of chronic viral hepatitis.

Summary: Current expert guidelines recommend earlier treatment of HIV infection in persons coinfected with hepatitis B virus and possibly hepatitis C virus. It is unknown whether an earlier start of ART is beneficial for the liver in HIV-monoinfected patients. Future research should focus on long-term ART-related hepatotoxicity.

© 2011 Lippincott Williams & Wilkins, Inc.

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