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HIV and Liver Disease

Thomas Monson, MD
JAMA. 2012;308(4):410-411. doi:10.1001/jama.308.4.410-b.
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In HIV and Liver Disease, Kenneth Sherman and contributors attempt to improve understanding of liver dysfunction in patients with human immunodeficiency virus (HIV), an entity that has evolved from an acute to a chronic illness.

Chapter 1 sketches current trends of the HIV epidemic, although the most recent data are from 2010. In the chapter on liver disease in HIV, Butt addresses well-recognized factors of drug-related liver injury: ethanol use and coinfection with hepatitis B virus (HBV) and hepatitis C virus (HCV). It is generally less appreciated that nonalcoholic fatty liver disease is relatively common, with magnetic resonance imaging and computed tomography studies reporting a 37% to 42% rate of steatosis among patients with HIV alone, increasing to 67% to 69% among those coinfected with HBV or HCV (pp 10-11). The degree of steatosis correlates with the risk of fibrosis. A special notation is also made of “nodular regenerative hyperplasia,” a newer entity perhaps 3 times more common in patients with vs without HIV.


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