THE PROGRESSION OF HCV-ASSOCIATED LIVER-DISEASE IN A COHORT OF HEMOPHILIC PATIENTS
THE PROGRESSION OF HCV-ASSOCIATED LIVER-DISEASE IN A COHORT OF HEMOPHILIC PATIENTS
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DOI：
10.1111/j.1365-2141.1994.tb08312.x
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发表时间：
1994-07-01
影响因子：
6.5
通讯作者：
LEE, C
中科院分区：
文献类型：
--
作者：
TELFER, P;SABIN, C;LEE, C
我们研究了在我们中心治疗的血友病患者中与丙型肝炎病毒感染相关的发病率和死亡率。11/255例HCV血清阳性患者发生肝功能失代偿。首次暴露于冻干凝血因子浓缩物后20年，肝功能失代偿的风险估计为10.8%（95% CI 3.8-17.8%）。感染艾滋病毒的风险显著增加，而且随着年龄的增长。对于HN血清阳性患者，CD 4淋巴细胞计数下降率和p24抗原血症的发展是肝失代偿的重要风险因素。19例HIV血清阳性患者中有9例在尸检时出现肝硬化。肝硬化与年龄增加有关，但与CD 4计数、p24抗原血症或艾滋病无关。总之，HCV感染与血友病患者的严重肝脏疾病有关，但到目前为止，这仅限于少数高危人群。HIV合并感染加速了肝脏失代偿的进展，我们推测这可能是由于免疫缺陷时HCV复制增强所致。
We have studied morbidity and mortality related to hepatitis C virus infection in haemophilic patients treated at our centre. 11/255 HCV seropositive patients have developed hepatic decompensation. 20 years after first exposure to lyophilized clotting factor concentrate the risk of hepatic decompensation is estimated to be 10.8% (95% CI 3.8-17.8%). There is a significantly increased risk associated with HIV infection, and also with increased age. For HN seropositive patients the rates of decline in CD4 lymphocyte count and the development of p24 antigenaemia are significant risk factors for hepatic decompensation. Cirrhosis was seen in 9/19 HIV seropositive patients at post mortem. There was an association of cirrhosis with increased age but not with CD4 count, p24 antigenaemia, or AIDS. In conclusion, HCV infection is associated with serious liver disease in haemophilic patients, but so far this has been restricted to a minority of those at risk. HIV coinfection accelerates progression to hepatic decompensation, and we speculate that this is probably due to enhanced HCV replication in the presence of immune deficiency.