Adverse effects of antiretroviral therapy on liver hepatocytes and endothelium in HIV patients: An ultrastructural perspective

Human immunodeficiency virus and antiretroviral therapy (ART) together can be far more detrimental to liver cells than either of the two unaided. However, ultrastructural aspects of the synergistic effects of HIV and ART have been understudied. In a patient cohort receiving ART, this study character...

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Bibliographic Details
Published in:Ultrastructural pathology 2017-03, Vol.41 (2), p.186-195
Main Authors: Chwiki, Sarah, Campos, Maria Mercedes, McLaughlin, Mary E., Kleiner, David E., Kovacs, Joseph A., Morse, Caryn G., Abu-Asab, Mones S.
Format: Article
Language:English
Subjects:
Anti-HIV Agents - adverse effects
Antiretroviral therapy
Chemical and Drug Induced Liver Injury - pathology
endothelium
Endothelium - drug effects
Endothelium - pathology
Endothelium - ultrastructure
Female
Hepatocytes - drug effects
Hepatocytes - pathology
Hepatocytes - ultrastructure
hepatotoxicity
HIV
HIV Infections - drug therapy
HIV Infections - pathology
Humans
liver
Male
Microscopy, Electron, Transmission
Middle Aged
mitochondria
sinusoid
steatosis
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Summary:Human immunodeficiency virus and antiretroviral therapy (ART) together can be far more detrimental to liver cells than either of the two unaided. However, ultrastructural aspects of the synergistic effects of HIV and ART have been understudied. In a patient cohort receiving ART, this study characterizes ultrastructurally sinusoidal degeneration, hepatocytic aberrations, mitochondrial dysfunction, accumulation of bulky lipid droplets (steatosis), and occlusion of sinusoidal lumina. Mitochondrial dysfunction causes the accumulation of acetyl-CoA which leads to insulin upregulation and resistance, lipid synthesis, and steatosis. Lipid droplets deposited in the sinusoids could be the source of the blood's lipid profile alterations in HIV patients on ART.
ISSN:0191-3123
1521-0758
DOI:10.1080/01913123.2017.1282066