Mechanisms of liver disease in patients infected with HIV.
Mechanisms of liver disease in patients infected with HIV.
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DOI：
10.1136/bmjgast-2017-000166
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发表时间：
2017
影响因子：
3.1
通讯作者：
Sterling RK
中科院分区：
文献类型：
--
作者：
Kaspar MB;Sterling RK
描述HIV感染患者肝脏疾病的各种机制，并将这些机制与可能利用它们的疾病状态联系起来。在慢性感染艾滋病毒的病人中，非艾滋病的发病和死亡原因越来越普遍。特别是，与肝脏有关的疾病已上升为非艾滋病相关死亡的主要原因之一。在评估和护理这些患者时，彻底了解这些患者肝脏疾病发展的机制至关重要。回顾和综合了关于不同疾病实体可能导致肝损伤和纤维化的肝病机制的文献。确定了许多离散的损伤机制，包括：氧化应激、线粒体损伤、脂毒性、免疫介导的损伤、细胞毒性、毒性代谢物积累、肠道微生物易位、全身性炎症、衰老和结节性再生性增生。疾病状态可以使用任何数量的这些机制来对肝脏发挥作用。HIV感染患者可能发生肝损伤的机制有很多。大多数疾病状态使用多种机制引起肝损伤和纤维化。
To describe the various mechanisms of liver disease in patients with HIV infection, and to link these mechanisms to disease states which may utilise them. Non-AIDS causes of morbidity and mortality are becoming increasingly common in patients chronically infected with HIV. In particular, liver-related diseases have risen to become one of the leading causes of non-AIDS-related death. A thorough understanding of the mechanisms driving the development of liver disease in these patients is essential when evaluating and caring for these patients. The literature regarding mechanisms of liver disease by which different disease entities may cause hepatic injury and fibrosis was reviewed and synthesised. A number of discrete mechanisms of injury were identified, to include: oxidative stress, mitochondrial injury, lipotoxicity, immune-mediated injury, cytotoxicity, toxic metabolite accumulation, gut microbial translocation, systemic inflammation, senescence and nodular regenerative hyperplasia. Disease states may use any number of these mechanisms to exert their effect on the liver. The mechanisms by which liver injury may occur in patients with HIV infection are numerous. Most disease states use multiple mechanisms to cause hepatic injury and fibrosis.
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