Author: Wei-Chen Huang, Yuting Lin
Review Article
Functional Role of Perilipins in Lipid Droplet Biogenesis and Expansion
Yuting Lin¹* and Wei-Chen Huang²
1Department of Microbiology, National Taiwan University, Taipei, Taiwan
2Department of Biotechnology, National Cheng Kung University, Tainan, Taiwan
Published: 16 July 2018
Abstract
Human Immunodeficiency Virus (HIV) infection is associated with a wide range of hepatic complications, including direct viral effects on hepatocytes, immune-mediated liver injury, and hepatotoxicity induced by Antiretroviral Therapy (ART). The liver plays a central role in drug metabolism, making HIV-infected individuals particularly susceptible to liver dysfunction, especially those undergoing Highly Active Antiretroviral Therapy (HAART). Hepatic complications in HIV patients are further exacerbated by co-infections with Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV), alcohol use, and metabolic disorders such as non-alcoholic fatty liver disease (NAFLD). The mechanisms of HIV-induced liver damage are multifaceted. HIV can directly infect hepatic stellate cells and Kupffer cells, leading to chronic inflammation, fibrosis, and liver injury. Additionally, the immune activation and systemic inflammation associated with HIV contribute to hepatocyte apoptosis and fibrosis progression. Co-infections with hepatotropic viruses further accelerate liver damage, increasing the risk of cirrhosis and hepatocellular carcinoma.
HAART has significantly improved the survival and quality of life of HIV-infected individuals. However, long-term HAART use is associated with hepatotoxicity, manifested as elevated liver enzyme levels, mitochondrial toxicity, and altered lipid metabolism. Certain antiretroviral drugs, particularly protease inhibitors and non-nucleoside reverse transcriptase inhibitors, have been implicated in liver enzyme elevations and drug-induced liver injury. Liver biomarkers play a crucial role in monitoring hepatic function in HIV patients. γ-Glutamyl Transpeptidase (GGTP), Alanine Aminotransferase (ALT), and Aspartate Aminotransferase (AST) are commonly used indicators of hepatocellular injury and cholestasis. Elevated levels of these enzymes serve as early markers of liver dysfunction and can guide clinical decisions regarding ART modification or additional interventions. Additionally, emerging biomarkers such as Fibrosis-4 (FIB-4) and AST-to-Platelet Ratio Index (APRI) have shown promise in assessing liver fibrosis and predicting disease progression. Understanding the interplay between HIV, HAART, and liver function is essential for optimizing the management of HIV-infected patients. Regular monitoring of liver biomarkers, early detection of hepatotoxicity, and personalized treatment approaches can help mitigate liver-related complications and improve long-term outcomes in HIV-positive individuals. Further research is needed to explore novel therapeutic strategies for reducing liver damage while maintaining effective HIV control.
Keywords: HIV; Liver dysfunction; HAART; Hepatotoxicity; Liver biomarkers; Co-infection; Hepatic fibrosis; Antiretroviral therapy
