April - June 2017
Non-Alcoholic Fatty Liver Disease and HIV/AIDS: a New Way of Modulation of Cardiovascular Risk
Department of Medicine and HIV Metabolic Clinic, Milton Keynes University Hospital NHS Foundation Trust, Eaglestone, Milton Keynes, Buckinghamshire, UK
With the advent and subsequent success of antiretroviral therapy, human immunodeficiency virus (HIV) infection has largely become a chronic condition and is increasingly seen alongside metabolic disorders such as dyslipidaemia and insulin resistance. Furthermore, the administration of antiretroviral therapy (ART) itself is associated with an increase in the incidence of metabolic risk factors (namely insulin resistance, lipoatrophy, dyslipidaemia, and abnormalities of fat distribution in HIV patients). Thus, further challenges in the management of HIV patients include the management of diabetes and the metabolic syndrome, non-alcoholic fatty liver disease (NAFLD). Importantly, HIV and NAFLD are both associated with increased risk of cardiovascular disease (CVD). Overall, the management of NAFLD and cardiovascular risks associated with HIV is complex and requires specialist management. Further research is needed to address the best strategies in the management of CVD in patients with HIV. This narrative review aims to discuss NAFLD and HIV infection, HIV and Cardiovascular disease (CVD) as well as how fatty liver modulate CVD in HIV patients.