NASH in HIV

Commentary

Ageing-related comorbidities, including liver disease, represent the main drivers of morbidity and mortality in people with HIV. NAFLD seems a frequent comorbidity in ageing people with HIV nowadays. Giada Sebastiani et al. (Division of Gastroenterology and Hepatology, Chronic Viral Illness Service Royal Victoria Hospital, McGill University Health Centre, Montreal, Canada) review the current status of knowledge regarding this emerging comorbidity in people with HIV, including epidemiology of NAFLD and NASH in HIV, Pathogenesis of NASH in the context of HIV infection, natural history, diagnosis and treatment.

Recent findings suggest that people with HIV are at higher risk for both NASH and NASH-related liver fibrosis. Several hypothesized pathogenic mechanisms may account for this finding. In clinical practice, non-invasive diagnostic tests may help identify patients with NASH-related fibrosis, thus improving risk stratification, and enhancing clinical management decisions.

Clinicians should remain informed of the frequency, significance, and diagnostic and management approach to NASH in people with HIV.