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. Author manuscript; available in PMC: 2011 Jul 30.
Published in final edited form as: Gastroenterology. 2009 Jun 21;137(3):795–814. doi: 10.1053/j.gastro.2009.06.040

Figure 3.

Figure 3

Influence of HIV-1 replication and its treatment on the liver in HCV coinfection. The red arrows represent the “vicious cycle” of immune activation and CD4 activation, infection, and depletion, as well as effects on the gut mucosa promoting microbial translocation that are proposed to be central to the immunopathogenesis on the liver. These may affect liver fibrosis by a variety of mechanisms. Treatment of HIV-1 by antiretroviral therapy may interrupt the above processes but may introduce additional issues that are on balance negative to liver disease.