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Hepatology：HIV/HCV共感染患者的肝纤维化进展迅速

2014-04-02 佚名 dxy

HIV/HCV共感染肝纤维化
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人免疫缺陷病毒HIV/丙肝病毒HCV共感染与进展性肝病相关。然而，进展的比例是多变的，并且在区分病人的HCV疾病处于稳定或进展状态上的能力十分有限。HIV/HCV共感染患者肝纤维化进展的速率和危险因素尚不明确。 来自美国约翰霍普金斯医院的Monica A. Konerman等人对此进行研究，结果发现HCV/HIV共感染患者的肝纤维化进展迅速。该研究结果发表在2014年3月的Hepatology上

人免疫缺陷病毒HIV/丙肝病毒HCV共感染与进展性肝病相关。然而，进展的比例是多变的，并且在区分病人的HCV疾病处于稳定或进展状态上的能力十分有限。HIV/HCV共感染患者肝纤维化进展的速率和危险因素尚不明确。

来自美国约翰霍普金斯医院的Monica A. Konerman等人对此进行研究，结果发现HCV/HIV共感染患者的肝纤维化进展迅速。该研究结果发表在2014年3月的Hepatology上。

本研究旨在探究纤维化进展在由共感染患者组成的前瞻性队列中的发病率和危险因素。研究分析了来自282名无肝硬化患者的435个肝活检对。根据METAVI系统，由一个不知活检顺序的病理学家对活检进行评分。纤维化进展定义为配对的活检间至少增加一个METAVIR纤维化期。

研究结果显示，大部分的患者为非裔美人（84.8%），男性占67.7%，HCV1感染占93.4%。243名患者在初次活检时为无或小量纤维化。活检的平均间隔为2.5年。282名患者中有97名（34%）有纤维化进展，而435个活检对中有149个（34%）有纤维化进展。

经校正后，初次活检时较高的体重指数、糖尿病和脂肪肝与纤维化进展轻微相关。活检间的血清天冬氨酸和丙氨酸转氨酶的增加(AST, ALT)与纤维化进展密切相关。

总之，纤维化进展常见于HIV/HCV共感染者，且数据显示进展是迅速。持续升高的血清转氨酶可能是一个重要的非侵入性标志，可以用来检测发生进展可能性较大的患者，保证更加密切的监测并考虑HCV治疗。

原始出处

Konerman MA1, Mehta SH, Sutcliffe CG, Vu T, Higgins Y, Torbenson MS, Moore RD, Thomas DL, Sulkowski MS.Fibrosis progression in human immunodeficiency virus/hepatitis C virus coinfected adults: Prospective analysis of 435 liver biopsy pairs.Hepatology. 2014 Mar

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    2014-08-13 仁心济世

    #肝纤维#

    0

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    2014-04-27 12498a1cm67暂无昵称

    #共感染#

    0

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    2014-04-04 ymljack

    #HCV#

    0

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    2014-04-04 gwc384

    #EPA#

    0