breaking down the foods we ingest and these digested products go to the liver.
Two things happen. First, by eating a poor diet, a diet high in saturated fats, simple carbohydrates, low in plant fiber, high in processed foods, the digested products going to the liver are not optimal. But, secondly, this poor diet produces a change in the microbiome. It is a change from bacteria that can produce products of good nutritional value to bacteria that may produce compounds that are actually harmful. And where do these products end up? That’s right, the liver!
Now, let’s talk NAFLD and HIV. Recall in the article on HIV and the Gut microbiome that HIV disease by itself can cause a shift in the microbiome from the “good” bacteria to the “not so good” bacteria. I also described how HIV infection produces a low-grade type of inflammation. So all the ingredients for developing NAFLD are already in place! Therefore, it was no surprise when a large study last year found that over one-third of people with HIV disease had NAFLD. HIV disease doubles the risk of developing NAFLD.
Some of the older drugs used to treat HIV could cause fat in the liver but these drugs are almost never used anymore. African-Americans suffer from the double whammy of metabolic syndrome and HIV at very high rates. I have worked to help patients manage these problems for over two decades.
Over that period, liver disease has steadily increased to be among the top 2-3 causes of death in this era of effective HIV therapy. The fact that many people with HIV disease also have Hepatitis C and Hepatitis B makes this even worse. Work with your medical providers and nutritionists to change your diet and increase physical activity. There are dozens of great articles on the blackdoctor.org website on how to prepare nutritious meals that are delicious and all sorts of ways to increase physical fitness.
Dr. Crawford has over 25 years of experience in the treatment of HIV. While at Howard University School of Medicine, he worked in two HIV-specialty clinics at Howard University Hospital. He then did clinical research as a visiting scientist with the AIDS Clinical Trials Group (ACTG) at Johns Hopkins University School of Medicine. He served as the Assistant Chief of Public Health Research with the Military HIV Research Program where he managed research studies under the President’s Emergency Plan for AID Relief (PEPFAR) in four African countries.
He is currently working in the Division of AIDS in the National Institutes of Health. He has published research in the leading infectious diseases journals and serves on the Editorial Board of the journal AIDS. Any views and perspectives in his articles on blackdoctor.org are not representative of any agency or organization but a reflection of his personal views.