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Disorders of the Liver Excluding Hepatitis A, B, C, D, and E

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Part of the Clinical Gastroenterology book series (CG)

Abstract

Liver disease is one of the most common non-AIDS-related causes of death in HIV-infected patients, but the incidence may be declining with advances in antiretroviral therapy (Jennifer and Thio, Clin Gastroenterol Hepatol 8:1002–1012, 2010; Pettit et al. J Int AIDS Soc 21, 2018; Sherman et al. Hepatology 62:1871–1882, 2015). Recognizing and treating opportunistic infections of the liver is essential in the care of HIV-infected patients. This chapter will review the epidemiology, pathophysiology, and clinical presentation along with diagnostic testing and treatment of the most common hepatic presentations of HIV opportunistic fungal, bacterial, viral, and mycobacterial diseases. This chapter will emphasize the less common and often non-hepatotropic viral infections. The more common viral hepatitides, hepatitis A, B, C, D, and E, will be discussed in greater detail in another chapter. In addition to infectious processes that can cause hepatic injury, treatment of HIV with HAART and other medications used for the treatment and prevention of opportunistic infections can lead to drug-induced liver injury (DILI). Since liver injury has a broad differential and can mimic vascular and neoplastic diseases, it takes an astute physician to recognize opportunistic infections and DILI that occur in HIV-infected persons. Clinicians must be aware of these potentially serious hepatic effects when managing HIV-positive patients.

Keywords

Human immunodeficiency virus (HIV) Opportunistic infections Antiretroviral therapy (ART) Drug-induced liver injury (DILI) Hepatitis Liver failure 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Division of Infectious DiseasesGeorgetown University Medical CenterWashington, DCUSA
  2. 2.Division of GastroenterologyGeorgetown University Medical CenterWashington, DCUSA

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