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人类免疫缺陷病毒感染患者的自身免疫性肝病:3个病例系列

Maria Ana Rafael¹, Filipa Bordalo Ferreira¹, Rita Theias Manso²

¹Gastroenterology Department, Hospital Prof. Doutor Fernando Fonseca, Amadora, Portugal.

GE Portuguese journal of gastroenterology

|November 29, 2023

概括

自身免疫性肝脏疾病,如初级胆管胆炎和自身免疫性肝炎,在感染人类免疫缺陷病毒 (HIV) 的患者中越来越多地被诊断出. 免疫抑制疗法是安全有效的,当艾滋病毒是通过抗逆转录病毒疗法 (ART) 控制.

科学领域:

肝病学肝病学是一种肝病学.
免疫学免疫学免疫学
传染性疾病传染性疾病

背景情况:

越来越多的人类免疫缺陷病毒 (HIV) 感染患者接受有效的抗逆转录病毒疗法 (ART) 导致自身免疫性疾病的诊断增加.
自身免疫性肝脏疾病 (AILDs),如原发性胆道胆炎 (PBC) 和自身免疫性肝炎 (AIH) 在感染艾滋病毒的人群中存在独特的挑战.
对免疫抑制疗法的安全性和有效性存在担忧,在这个免疫受损人群中.

研究的目的:

在艾滋病毒感染患者中呈现三个不同的AILD病例.
描述用于每个病例的诊断和治疗策略.
突出免疫抑制治疗在控制病毒载荷的HIV患者的安全性和可行性.

主要方法:

病例报告系列详细介绍了三个被诊断患有AILD的HIV阳性患者.
对诊断工作的审查,包括血清学标记物和肝脏活检.
对各种免疫抑制剂和ART的治疗反应的分析.

主要成果:

案例1:原发性胆道胆炎 (PBC) 具有自身免疫性肝炎 (AIH) 的特征,需要二线治疗.
案例2:自身免疫性肝炎 (AIH) 具有PBC特征,晚期纤维化和之前的细胞巨乳病毒感染.
案例3:具有急性肝损伤的自身免疫性肝炎 (AIH),用皮质类固醇和阿扎西奥普林成功治疗.

结论:

自免疫性肝脏疾病是越来越多的艾滋病毒感染者在ART中出现的一个新兴问题.
免疫抑制疗法可以安全地给艾滋病毒患者服用,只要他们的艾滋病毒被ART病毒学上抑制.
个性化诊断和治疗方法对于在这个特定的患者群体中管理AILD至关重要.

关键词:

自体免疫性肝炎是一种自身免疫性肝炎.人类免疫缺陷病毒人类免疫缺陷病毒免疫复合综合征免疫复合综合征原发性胆道胆管炎是一种胆道胆管炎.

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