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NAFLD and HIV: Do Sex, Race, and Ethnicity Explain HIV-Related Risk?

  • Complications of Antiretroviral Therapy (GA McComsey, Section Editor)
  • Published:
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Abstract

Purpose of Review

Here, we review the epidemiology, diagnosis, and management of non-alcoholic fatty liver disease (NAFLD) in the general population, discuss HIV-specific differences in NAFLD pathogenesis, and summarize what is known regarding differences in NAFLD by race/ethnicity and sex.

Recent Findings

The reported prevalence of NAFLD among people living with HIV varies by age, body mass index, comorbidity, and method of NAFLD diagnosis, but is generally thought to be greater among HIV-infected compared to HIV-uninfected populations. Minorities and women tend to experience poorer HIV treatment outcomes (Meditz et al. J Infect Dis. 203(4):442–51, 2011; Beer et al. Medicine (Baltimore). 95(13):e 3171, 2016; Gant et al. MMWR Morb Mortal Wkly Rep. 66(40):1065–72, 2017; Millett et al. Lancet. 380(9839):341–8, 2012; Wejnert et al. J Infect Dis. 213(5):776–83, 2016), and are at the greatest risk for significant weight gain with HIV treatment (Erlandson et al. Medicine (Baltimore). 95(46):e 5399, 2016). Thus, women and minorities living with HIV may be at a higher risk of developing NAFLD and progressive liver disease.

Summary

Disparities in the diagnosis, progression, and prognosis of NAFLD and HIV-associated NAFLD may be, in part, explained by genetic and sex differences; however, data is limited.

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Acknowledgements

This work was supported by the National Institute on Aging of the National Institutes of Health (K23 AG050260 and R01 AG054366 to K.M.E.), the National Institute of Allergy and Infectious Diseases (K23 AI110532 to J.E.L.), and the National Institute of Diabetes and Digestive and Kidney Diseases (K23 DK099422 to K.E.C.). The contents are solely the responsibility of the authors and do not necessarily represent the official views of NIH.

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Authors and Affiliations

  1. School of Medicine, University of Colorado–Anschutz Medical Campus, Aurora, CO, USA

    Subada Soti

  2. Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA

    Kathleen E. Corey

  3. University of Texas Health Sciences Center, Houston, TX, USA

    Jordan E. Lake

  4. Department of Medicine, Division of Infectious Diseases, University of Colorado–Anschutz Medical Campus, 12700 E. 19th Avenue, Mail Stop B168, Aurora, CO, 80045, USA

    Kristine M. Erlandson

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  1. Subada Soti
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Correspondence to Kristine M. Erlandson.

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S.S. and K.E.C. declare no conflict of interest.

J.E.L. has served as a consultant to Merck and receives research funding from Gilead Sciences.

K.M.E. has received research funding (paid to the University of Colorado) from Gilead Sciences and has served as a consultant to Gilead Sciences, EMD Serono, and Theratechnologies.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Complications of Antiretroviral Therapy

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Soti, S., Corey, K.E., Lake, J.E. et al. NAFLD and HIV: Do Sex, Race, and Ethnicity Explain HIV-Related Risk?. Curr HIV/AIDS Rep 15, 212–222 (2018). https://doi.org/10.1007/s11904-018-0392-1

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