The role of non-alcoholic fatty liver disease in bacterial infections and sepsis

Abstract

Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease associated with systemic changes in immune response that drives the progression to non-alcoholic steatohepatitis (NASH), liver cirrhosis, and hepatocellular carcinoma (HCC). Major risk factors of NAFLD include obesity and type 2 diabetes mellitus which are associated with infections. However, there is growing evidence that NAFLD is linked with bacterial infections independently of other components of metabolic syndrome. Patients with NAFLD have been described to have more common recurrent bacterial infections, urinary tract infections, bacteriemia of gastrointestinal origin, Clostridoides difficile enterocolitis, and more severe pneumonia. The rapidly increasing prevalence of NAFLD and NASH require novel therapeutic and prophylactic approaches based on a better understanding of immunopathogenesis of bacterial infections in these patients.

Keywords

• non-alcoholic fatty liver disease – complications
• epidemiology
• immunology; liver – immunology; bacterial infections – epidemiology
• etiology; sepsis – epidemiology