Effects of Angiotensin Converting Enzyme Inhibitors on Liver Fibrosis in HIV and Hepatitis C Coinfection.
Effects of Angiotensin Converting Enzyme Inhibitors on Liver Fibrosis in HIV and Hepatitis C Coinfection.
复制标题
血管紧张素转换酶抑制剂对 HIV 和丙型肝炎合并感染肝纤维化的影响。
DOI：
10.1155/2012/978790
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发表时间：
2012
影响因子：
1.7
通讯作者：
Fishbein,DawnA
中科院分区：
文献类型：
--
作者：
Reese,LindseyJ;Tider,DianeS;Stivala,AliciaC;Fishbein,DawnA
背景。 HIV 和丙型肝炎合并感染时，肝纤维化会加速，这是由血管紧张素的促纤维化作用介导的。 本研究的目的是确定血管紧张素转换酶抑制剂 (ACE-Is) 是否可以减轻合并感染中的肝纤维化。方法。对 156 名合并感染受试者进行回顾性分析，分析 ACE-Is 暴露与肝纤维化之间的关联。比较了服用 ACE-Is 的受试者和未服用 ACE-Is 的对照组之间的非侵入性肝纤维化指数（APRI、FIB-4、Forns 指数）。使用线性回归来评估 ACE-I 作为纤维化独立预测因子的用途。结果。服用 ACE-Is 三年的受试者在 APRI 和 FIB-4 上与对照组没有什么不同，但 Forns 指数的得分明显高于对照组，表明纤维化程度更高。当根据年龄、种族和 HIV 病毒载量进行调整后，使用 ACE-Is 三年仍然与 Forns 评分升高独立相关（P < 0.001）。根据临床和放射学的确定，所有指数与显着纤维化之间存在显着相关性。结论。合并感染时血管紧张素抑制与肝纤维化之间不存在保护性关联。 这些非侵入性指标可能有助于排除合并感染中的显着纤维化。
Background. Liver fibrosis is accelerated in HIV and hepatitis C coinfection, mediated by profibrotic effects of angiotensin. The objective of this study was to determine if angiotensin converting enzyme inhibitors (ACE‐Is) attenuate liver fibrosis in coinfection.Methods. A retrospective review of 156 coinfected subjects was conducted to analyze the association between exposure to ACE‐Is and liver fibrosis. Noninvasive indices of liver fibrosis (APRI, FIB‐4, Forns indices) were compared between subjects who had taken ACE‐Is and controls who had not taken them. Linear regression was used to evaluate ACE‐I use as an independent predictor of fibrosis.Results. Subjects taking ACE‐Is for three years were no different than controls on the APRI and the FIB‐4 but had significantly higher scores than controls on the Forns index, indicating more advanced fibrosis. The use of ACE‐Is for three years remained independently associated with an elevated Forns score when adjusted for age, race, and HIV viral load (P< 0.001). There were significant associations between all of the indices and significant fibrosis, as determined clinically and radiologically.Conclusions. There was not a protective association between angiotensin inhibition and liver fibrosis in coinfection. These noninvasive indices may be useful for ruling out significant fibrosis in coinfection.