41. Hepatobiliary Manifestations of Human Immunodeficiency Virus

  1. Eugene R. Schiff MD, MACP, FRCP3,
  2. Willis C. Maddrey MD, MACP, FRCP4 and
  3. Michael F. Sorrell MD, FACP5
  1. Marie-Louise Vachon MD1,
  2. Ponni Perumalswami MD1 and
  3. Douglas T. Dieterich MD2

Published Online: 31 OCT 2011

DOI: 10.1002/9781119950509.ch41

Schiff's Diseases of the Liver, Eleventh Edition

Schiff's Diseases of the Liver, Eleventh Edition

How to Cite

Vachon, M.-L., Perumalswami, P. and Dieterich, D. T. (2011) Hepatobiliary Manifestations of Human Immunodeficiency Virus, in Schiff's Diseases of the Liver, Eleventh Edition (eds E. R. Schiff, W. C. Maddrey and M. F. Sorrell), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781119950509.ch41

Editor Information

  1. 3

    Center for Liver Diseases and Schiff Liver Institute, University of Miami Miller School of Medicine, Miami, FL, USA

  2. 4

    Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA

  3. 5

    University of Nebraska College of Medicine, Omaha, NE, USA

Author Information

  1. 1

    Mount Sinai School of Medicine, New York, NY, USA

  2. 2

    Mount Sinai School of Medicine, Division of Liver Diseases, New York, NY, USA

Publication History

  1. Published Online: 31 OCT 2011
  2. Published Print: 9 DEC 2011

ISBN Information

Print ISBN: 9780470654682

Online ISBN: 9781119950509



  • HIV;
  • hepatitis B virus (HBV);
  • hepatitis C virus (HCV);
  • coinfection;
  • antiretroviral therapy (ART);
  • steatohepatitis;
  • liver transplantation;
  • opportunistic infections


The development of chronic liver diseases in human immunodeficiency virus (HIV)-infected patients is a growing concern. Coinfection with chronic hepatitis viruses is more frequent in the HIV population because of shared routes of transmission and a lower likelihood of spontaneous clearance. Liver injury in the setting of coinfection is accelerated and leads to a higher rate of complications, resulting in increased morbidity and mortality in this population. Antiretroviral therapy (ART) has substantially decreased the incidence of opportunistic infections, although in immunosuppressed HIV-infected patients the liver and biliary tract are frequent sites of infection. HIV infection and long-term ART are associated with metabolic complications, lipodystrophy, insulin resistance, steatosis, and steatohepatitis, which contribute to the increasing burden of liver disease in HIV-infected patients. Hepatocellular carcinoma is an increasing complication of chronic liver disease in these patients. Fortunately, liver transplant is a promising treatment option for HIV-infected patients with end-stage liver disease.