HIV感染患者の肝臓疾患の負担が増加しています
Deepak Joshi1, John O'Grady, Doug Dieterich
1Institute of Liver Studies, King's College Hospital, London, UK.
Lancet (London, England)
|April 5, 2011
まとめ
効果的なHIV治療は,HIVを慢性状態に変容させますが,ウイルス共感染や非アルコール性脂肪肝疾患による肝疾患のリスクを高めます. 管理戦略は,患者のアウトカムを改善するために不可欠です.
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.
- 免疫学 免疫学とは
背景:
- 併用抗レトロウイルス療法 (cART) は,ヒト免疫不全ウイルス (HIV) 感染症を慢性的に管理可能な状態にしました.
- cARTはエイズ関連の死亡率を低下させる一方で,肝臓疾患の負担は,ウイルス性共感染 (B型肝炎とC型肝炎),非アルコール性脂肪肝疾患 (NAFLD),薬物誘発性肝損傷 (DILI),肝細胞癌 (HCC) により増加しています.
研究 の 目的:
- HIV感染者における肝疾患の主な原因と病原性の包括的な概要を提示する.
- 肝臓移植の役割を含む,HIV管理の文脈で肝臓疾患の現在のおよび新興の治療戦略について議論する.
主な方法:
- HIVと肝臓疾患に関する既存の研究の文献レビューと合成.
- HIV感染者における肝臓併発症に関する疫学データと臨床研究の分析.
主要な成果:
- B型肝炎およびC型肝炎ウイルスとのHIV共感染は,肝臓の罹病率と死亡率に大きく寄与します.
- 非アルコール性脂肪肝疾患と薬物誘発性肝毒性は,HIV陽性集団における肝疾患の主要な要因としてますます認識されています.
- 肝細胞癌の発症は大きな懸念事項であり,積極的なスクリーニングと管理が必要である.
結論:
- ウイルス性肝炎,NAFLD,DILI,HCCに対処する統合管理戦略は,HIVに感染した患者の肝疾患を緩和するために不可欠です.
- 肝臓移植の役割は進化しており,HIV関連の合併症による末期肝疾患の選択された患者にとって有効な選択肢を提供することがあります.
さらに関連する動画
12:24A Three-Dimensional Spheroid Model to Investigate the Tumor-Stromal Interaction in Hepatocellular Carcinoma
Published on: September 30, 2021
07:21Processing of Bronchoalveolar Lavage Fluid and Matched Blood for Alveolar Macrophage and CD4+ T-cell Immunophenotyping and HIV Reservoir Assessment
Published on: June 23, 2019
関連する概念動画
01:26Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow
Chronic liver disease significantly impacts drug metabolism due to alterations in hepatic blood flow and enzyme accessibility. This disruption affects the body's pharmacokinetics—the movement and processing of drugs within the system. Key enzymes crucial for metabolizing medications become less accessible, changing how drugs are processed and utilized. Furthermore, liver disease influences the synthesis of plasma proteins, such as albumin and globulins, which play critical roles in drug binding...
01:22Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test
In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess the...
01:29Pulmonary Tuberculosis I
Tuberculosis, often called TB, is a contagious illness primarily caused by Mycobacterium tuberculosis. It mainly affects the lung parenchyma but can also impact other body parts.
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
01:08Effect of Hepatic Disease on Pharmacokinetics: Dose Adjustments Due to Hepatic Impairment
Hepatic impairment, characterized by decreased liver function, does not uniformly mandate adjustments in drug dosage. Whether dosage modifications are necessary depends on various factors related to the drug's metabolism and elimination pathways. If a drug is primarily excreted via the kidneys and bypasses significant hepatic processing, if it undergoes minimal metabolic transformation in the liver, or if it is volatile and primarily expelled through the lungs, dose adjustments may not be...
01:26Diseases of the Liver and Gallbladder
Liver and gallbladder diseases are a significant health concern, with prominent conditions including cirrhosis, hepatitis, non-alcoholic fatty liver disease (NAFLD), and gallstones. Jaundice is a common manifestation of liver and biliary disease.
Cirrhosis is characterized by the scarring of hepatic lobules in the liver, which are replaced by fibrous tissue, affecting the liver's normal functioning. NAFLD, on the other hand, is caused by an excessive build-up of fat in the liver, not related to...
Cirrhosis is characterized by the scarring of hepatic lobules in the liver, which are replaced by fibrous tissue, affecting the liver's normal functioning. NAFLD, on the other hand, is caused by an excessive build-up of fat in the liver, not related to...
01:25Hepatitis
Hepatitis is an inflammatory condition of the liver most commonly caused by hepatotropic viruses (A–E), though non-infectious causes such as alcohol and drugs also exist.Hepatitis AHepatitis A virus (HAV) is a non-enveloped RNA virus of the Picornaviridae family. It is primarily transmitted via the fecal-oral route, typically through ingestion of contaminated food or water. After ingestion, HAV enters the bloodstream through the oropharynx or intestinal epithelium and reaches the liver. The...