title: Aging of the Liver: What This Means for Patients with HIV.
abstract: As the HIV population continues to live longer as a result of antiretroviral therapy, liver-related mortality has become one of the leading causes of non-AIDS related death in this patient population. The liver possesses a remarkable regenerative capacity but undergoes complex biological changes in response to aging and inflammation that result in decreased cellular regeneration and a tipping of the scales towards fibrogenesis. Patients with HIV infection have serological evidence of ongoing inflammation, with elevations in some biomarkers persisting despite adequate virologic control. In addition, HIV-co-infected patients have markers of advanced age on liver biopsy and increased prevalence of fibrosis as compared to an age-matched HCV mono-infected cohort. In this review, we will discuss the biology of aging, age-related changes in the liver, and the relevant mechanisms by which HIV causes inflammation in the context of accelerated aging, fibrosis of the liver, and other viral co-infection.
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine, 315 Trent Dr, PO Box 102359, Durham, NC, 27710, USA. awc23@duke.edu.
authors.forename: Austin W
authors.initials: AW
authors.lastname: Chan
authors.affiliation: Division of Gastroenterology, Department of Medicine, Duke University School of Medicine, Durham, NC, USA.
authors.forename: Yuval A
authors.initials: YA
authors.lastname: Patel
authors.affiliation: Division of Gastroenterology, Durham VA Medical Center, Duke University School of Medicine, Durham, NC, USA.
authors.forename: Steve
authors.initials: S
authors.lastname: Choi
mesh_terms: D000375:Aging / Q000502:physiology*; D044966:Anti-Retroviral Agents / Q000009:adverse effects* / Q000627:therapeutic use; D056486:Chemical and Drug Induced Liver Injury; D060085:Coinfection; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D008099:Liver / Q000187:drug effects*; D008103:Liver Cirrhosis / Q000209:etiology*
chemical_list: D044966:Anti-Retroviral Agents
keywords: Aging; Co-infections; Fibrogenesis; HIV; Immunosenescence; Liver