HIV-1,B型肝炎ウイルス,およびマルチセンターコホート研究 (MACS) での肝臓関連死亡リスク
Chloe L Thio1, Eric C Seaberg, Richard Skolasky
1Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA. cthio@jhmi.edu
Lancet (London, England)
|December 21, 2002
まとめ
HIV-1およびB型肝炎ウイルス (HBV) の併感染は,肝臓関連の死亡率を著しく増加させ,特にCD4+値が低い個体では特にそうである. B型肝炎の総合的な管理は,HIV-1感染者にとって極めて重要です.
科学分野:
- 肝臓病理学 肝臓病理学
- 感染症 感染症は感染症です.
- 公衆衛生は公衆衛生である.
背景:
- ヒト免疫不全ウイルス1型 (HIV-1) とB型肝炎ウイルス (HBV) との共感染が一般的です.
- 同感染者における肝疾患による死亡率に関する長期的なデータは少ない.
- この研究は,HIV-1およびHBV感染のリスクのあるコホートにおける肝関連の死亡率を評価することを目的とした.
研究 の 目的:
- HIV-1とHBV共感染が肝臓関連の死亡率に与える影響を調査する.
- 同感染者における肝臓死亡率の増加に関連する危険因子を特定する.
主な方法:
- 男性とセックスをする5293人の男性を対象とした多センター,前向きなコホート研究.
- HIV-1抗体状態とB型肝炎表面抗原 (HBsAg) 状態に基づいて分類する.
- 死亡率は人年数とプアソン回帰を用いて推定された.
主要な成果:
- 肝臓関連の死亡率は1000人当たり1.1人でした.
- 死亡率は,HIV-1とHBsAgで共感染した個体 (14.2/1000) で,単発感染した個体と比較して有意に高かった.
- 死亡率が高いのは,CD4+細胞数が低い共感染者および高度に活性な抗レトロウイルス療法 (HAART) の導入後に観察された.
結論:
- HIV-1とHBVの併感染は,肝臓関連の死亡率に大きなリスクをもたらす.
- 低CD4+ナディール値は,共感染者の死亡率の増加と関連しています.
- HIV-1感染者集団におけるB型肝炎の予防,早期発見,統合管理の必要性を強調する.
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