January - March 2013
The Changing Epidemiology of Liver Disease in HIV Patients
Department of Infectious Diseases, Hospital Carlos III, Madrid, Spain
Liver disease continues to be one of the leading causes of hospitalization and death in HIV-infected individuals. Important etiologies include both alcoholic and non-alcoholic steatohepatitis, and coinfection with hepatitis viruses B and C. While non-alcoholic fatty liver disease is increasingly diagnosed in this population, most cases of chronic hepatitis B can be well controlled with tenofovir-based regimens, and hepatitis C has entered a revolutionary era in which most patients may be cured with direct-acting antivirals. However, important gaps remain unaddressed. Hepatitis delta is a neglected disease, despite 15 million people being infected worldwide, and represents the most severe form of viral hepatitis. Hepatitis E is largely unrecognized, despite being the major cause of acute viral hepatitis worldwide and occasionally leading to chronicity in immunosuppressed individuals.
Hepatitis C. HIV. Hepatitis B. Hepatitis delta. Hepatitis E. Antiviral therapy.