Infectious Complications of Acute and Chronic Liver Disease

Bettina Leber; Walter Spindelboeck; Vanessa Stadlbauer

doi:10.1055/s-0032-1301737

Seminars in Respiratory and Critical Care Medicine, Table of Contents

Semin Respir Crit Care Med 2012; 33(01): 80-95
DOI: 10.1055/s-0032-1301737

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Infectious Complications of Acute and Chronic Liver Disease

Authors

Bettina Leber

²Division of Transplantation Surgery, Medical University of Graz, Graz, Austria.
Walter Spindelboeck

¹Division of Gastroenterology and Hepatology, Medical University of Graz, Graz, Austria.
Vanessa Stadlbauer

¹Division of Gastroenterology and Hepatology, Medical University of Graz, Graz, Austria.

Abstract

Acute and chronic liver diseases are frequently complicated by infections, which result in increased morbidity and mortality and place an economic burden on health care systems. This review discusses the epidemiology and the impact on prognosis of infections in liver cirrhosis, nonalcoholic fatty liver disease/nonalcoholic steatohepatitis, acute liver failure, and post–liver transplantation. Possible mechanisms for this increased susceptibility are innate immune dysfunction (Kupffer cells, neutrophils, monocytes), genetic predisposition, and intrinsic cellular defects. The causes for innate immune dysfunction may lie in increased gut permeability, the occurrence of endotoxemia, albumin and lipoprotein dysfunction, or toll-like receptor expression. From a clinical viewpoint this article discusses problems in diagnosing infection. Established (vaccination, antibiotic prophylaxis, antiviral prophylaxis, and nutrition) and experimental (probiotic) prophylactic strategies as well as established (antibiotics) and experimental (liver support, albumin, toll-like receptor antagonists) strategies are also reviewed.

Keywords

infection - liver cirrhosis - acute liver failure - immune dysfunction

Full Text

References

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