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World J Gastroenterol. May 28, 2011; 17(20): 2500-2506
Published online May 28, 2011. doi: 10.3748/wjg.v17.i20.2500
Mechanisms of alcohol-mediated hepatotoxicity in human-immunodeficiency-virus-infected patients
Gyongyi Szabo, Samir Zakhari
Gyongyi Szabo, Department of Medicine, LRB-208, University of Massachusetts Medical School, Worcester, MA 01605, United States
Samir Zakhari, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD 20892, United States
Author contributions: Szabo G and Zakhari S contributed equally to writing this review.
Correspondence to: Gyongyi Szabo, MD, PhD, Professor, Associate Dean for Clinical and Translational Sciences, Director, MD/PhD Program, Vice Chair for Research, Department of Medicine, LRB-208, University of Massachusetts Medical School, 364 Plantation Street, Worcester, MA 01605, United States. gyongyi.szabo@umassmed.edu
Telephone: +1-508- 8565275 Fax: +1-508- 8564770
Received: January 21, 2011
Revised: April 19, 2011
Accepted: April 26, 2011
Published online: May 28, 2011
Abstract

Clinical observations have demonstrated that excessive chronic alcohol use negatively affects human immunodeficiency virus (HIV) infection and contributes to the liver manifestations of the disease, even in HIV mono-infection. HIV/hepatitis C virus (HCV) co-infection is associated with increased progression of HVC liver disease compared to HCV infection alone, and both of these are negatively affected by alcohol use. Recent data suggest that alcohol use and HIV infection have common targets that contribute to progression of liver disease. Both HIV infection and chronic alcohol use are associated with increased gut permeability and elevated plasma levels of lipopolysaccharide; a central activator of inflammatory responses. Both alcoholic liver disease and HIV infection result in non-specific activation of innate immunity, proinflammatory cytokine cascade upregulation, as well as impaired antigen presenting cell and dendritic cell functions. Finally, alcohol, HIV and antiretroviral therapy affect hepatocyte functions, which contributes to liver damage. The common targets of alcohol and HIV infection in liver disease are discussed in this mini-review.

Keywords: Hepatitis C virus, Hepatitis B virus, Liver, Intestine, Inflammation