HIV感染合并非酒精性脂肪肝病的诊疗新进展

Progress on diagnosis and treatment of HIV infection with nonalcoholic fatty liver disease

cART可有效控制HIV复制,显著延长HIV/AIDS患者的寿命,但非艾滋病相关并发症的发生率也上升,并成为HIV/AIDS患者死亡最主要的原因。近年来,HIV感染合并非酒精性脂肪肝病(NAFLD)发病率迅速增长,成为当前关注焦点。HIV/AIDS患者发生NAFLD与年龄、性别等多种因素相关,筛查和诊断依靠影像学与血清学检查,治疗方式与HIV阴性人群相似(饮食和运动、治疗并发症、护肝等),同时需优化cART方案。本文拟对该病的流行病学、诊断和治疗的最新研究进展进行综述,以提高诊治水平。

Combination antiretroviral therapy(cART)can effectively suppress HIV replication and greatly prolong the lifespan of people living with HIV(PLWH).However,non-AIDS-related comorbidities are increasing and now represent the primary cause of mortality in PLWH.In recent years,the concomitant occurrence of non-alcoholic fatty liver disease(NAFLD)in PLWH has become the research focus.The occurrence of NAFLD in PLWH is influenced by multiple factors,including age and gender.Screening and diagnosis rely on imaging and serum tests,while treatment approaches are similar to those for HIV-negative individuals(including diet and exercise,management of comorbidities,and liver protection).Additionally,optimization of cART regimens is necessary.This article aims to provide a comprehensive review of the latest research advancements in the epidemiology,diagnosis,and treatment of HIV infection with nonalcoholic fatty liver disease to enhance the level of diagnosis and management.