Steven Grinspoon, MD, on the Association Between HIV and Steatosis
In this video, Steven Grinspoon, MD, talks about the association between HIV and Steatosis and why patients with HIV are at an increased risk of steatosis.
- Grinspoon, SK. Mechanisms and treatments of steatosis in HIV. Presented at: Conference on Retroviruses and Opportunistic Infections 2021; March 7-10, 2021. https://ww2.aievolution.com/cro2101/index.cfm?do=abs.viewAbs&abs=1032
- Stanley TL, Fourman LT, Feldpausch MN, et al. Effects of tesamorelin on non-alcoholic fatty liver disease in HIV: a randomised, double-blind, multicentre trial [published online October 29, 2019]. Lancet HIV. https://doi.org/10.1016/S2352-3018(19)30338-8.
Steven K. Grinspoon, MD, is a professor of medicine and director of the Nutrition Obesity Research Center at Harvard Medical School in Boston, Massachusetts. He is also the chief of the Metabolism Unit and the MGH Endowed Chair in Neuroendocrinology and Metabolism at Massachusetts General Hospital in Boston, Massachusetts.
Dr Steven Grinspoon: I'm Dr. Steven Grinspoon. I'm a professor of medicine at Harvard Medical School. I'm Chief of the Metabolism Unit at MGH, and I've had a long‑standing interest in the metabolic complications of HIV, including fatty liver disease.
They may be at increase weight, and there are some ART regimens, for example, integrase inhibitors that may be associated with increased weight and waist circumference that may contribute. Number two, if you think about the mechanisms of fatty liver disease, insulin resistance is a really important one and that's common in HIV‑infected patients.
Insulin resistance leads to a breakdown of fat in the periphery, and that fat can travel to the liver and get accumulated in the liver as fat. Insulin resistance leads to further development of fat in the liver. In that regard, it's called de novo lipogenesis.
HIV‑infected patients who are having increased obesity and higher prevalence of visceral adiposity, that fat around your organs that is connected through the liver via the portal system are having a higher prevalence of that.
Insulin resistance, as well as inflammation and immune activation, it's kind of a perfect storm in which they may have excess fat and that fat may be associated with inflammation in the liver.
I'd like to thank the audience who are watching this and for the people who participate in the symposium. Thank you so much.