Current Hepatology Reports

, Volume 18, Issue 4, pp 482–491 | Cite as

HIV-Associated NAFLD: Disease Burden and Management

  • Alyson Kaplan
  • Jennifer C. PriceEmail author
Fatty Liver Disease (V Ajmera, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Fatty Liver Disease


Purpose of Review

Highly potent anti-retroviral therapy (ART) for the treatment of human immunodeficiency virus (HIV) has led to dramatic improvements in quality of life and lifespan in persons living with HIV (PLWH). PLWH, however, are suffering from other comorbid conditions, including non-alcoholic fatty liver disease (NAFLD). This review summarizes the epidemiology and pathophysiology of NAFLD in PLWH and explores unique diagnostic and treatment considerations in this population.

Recent Findings

Though it is well established that there is a high prevalence of NAFLD in PLWH, the mechanisms underlying NAFLD in this population are just beginning to be explored. Traditional NAFLD risk factors, including insulin resistance, visceral adiposity, and genetics, have been consistently linked with NAFLD in PLWH. In addition, HIV-related factors including mitochondrial dysfunction, microbiome alterations, and direct effects of the virus and of ART may play a role.


Given the burden of NAFLD in PLWH, further studies are necessary to investigate mechanisms specific to HIV with which to target therapies.


Human immunodeficiency virus Non-alcoholic fatty liver disease Non-alcoholic steatohepatitis Anti-retrovirals Persons living with HIV 



Human immunodeficiency virus


Non-alcoholic fatty liver disease


Non-alcoholic steatohepatitis


Anti-retroviral therapy


Persons living with HIV


Compliance with Ethical Standards

Conflict of Interest:

Alyson Kaplan declares no potential conflicts of interest.

Jennifer C. Price reports grants from Gilead Sciences and Merck and ownership interest (spouse) in Abbvie, Bristol-Myers Squibb, Johnson and Johnson, and Merck, and is an advisory board member of Surrozon.

Human and Animal Rights and Informed Consent

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


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Authors and Affiliations

  1. 1.Division of Gastroenterology, Department of MedicineWeill Cornell School of Medicine, New York PresbyterianNew YorkUSA
  2. 2.Division of Gastroenterology, Department of MedicineUniversity of San Francisco CaliforniaSan FranciscoUSA

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