艾滋病毒感染者和高转氨基酶水平患者的非病毒性肝病负担:一项跨部门研究
Dev Katarey1,2, Yishi Tan1, Adele Mourad1,2
1Department of Gastroenterology and Hepatology, University Hospitals Sussex NHS Foundation Trust, Brighton, United Kingdom.
Journal of acquired immune deficiency syndromes (1999)
|October 13, 2023
概括
许多艾滋病毒感染者 (PLWH) 患有临床显著肝纤维化 (CSHF). 危险的酒精使用,代谢综合征和某些抗逆转录病毒药物是需要注意的关键危险因素.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
背景情况:
- 艾滋病毒感染者 (PLWH) 预期寿命的提高导致肝脏疾病的认识增加.
- 非病毒性慢性肝病是PLWH人群日益关注的问题.
研究的目的:
- 评估PLWH中非病毒性慢性肝病的负担.
- 在这个队列中确定临床显著肝纤维化 (CSHF) 的患病率和预测因素.
主要方法:
- 预期招募具有高ALT和负性肝炎血清学的PLWH (HIV非病毒性肝病研究,2014-2021年).
- 肝硬性 (肝硬度>7.1kPa) 和危险的酒精使用 (AUDIT评分≥8) 的定义.
- 评估风险因素,包括代谢综合征和抗逆转录病毒暴露.
主要成果:
- 肝硬化的患病率为20% (n=54),其中7%患有肝硬化.
- 危险的酒精使用 (35%),代谢综合征 (26%) 和肝毒性抗逆转录病毒药物 (17-27%) 是常见的.
- CSHF的独立预测因素包括较低的HDL,较高的AST和迪达诺辛使用. 在52%的患者中,发现了中度至重度的肝肥胖症.
结论:
- 研究中20%的PLWH患有CSHF,这与高水平的危险酒精使用,代谢综合征和潜在的肝毒性抗逆转录病毒药物有关.
- 这些可修改的风险因素需要在PLWH管理中采取有针对性的干预措施.
- 标准纤维化得分 (FIB-4,APRI) 对CSHF和晚期纤维化的预测值不佳.
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