Clinical outcomes of HIV-HCV co-infection in a large cohort of hemophiliac patients
Clinical outcomes of HIV-HCV co-infection in a large cohort of hemophiliac patients
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DOI：
10.1016/j.jinf.2004.04.003
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发表时间：
2005-04-01
影响因子：
28.2
通讯作者：
Rockstroh, JK
中科院分区：
文献类型：
--
作者：
Lichterfeld, M;Schmeisser, N;Rockstroh, JK
Objective.确定在单一医疗机构接受治疗的大型患者队列（n = 288）中HIV-HCV合并感染的血友病患者的疾病进展。患者和方法。计算艾滋病和肝脏相关死亡的年死亡率，绘制Kaplan-Meier生存曲线以确定艾滋病和死亡的进展。1985年1月至2002年12月，这些患者中分别有179人（62.2%）和195人（67.7%）发展为艾滋病或死亡。总的来说，艾滋病造成128人死亡，几乎全部（93.7%）是在1995年底采用高效抗逆转录病毒疗法之前发生的。共有29例患者死于肝功能衰竭，其中大多数（69%）发生在1991 - 1996年。自1997年以来，仅报告了5例致死性肝衰竭病例。非HIV-HCV相关原因导致38例死亡，主要发生在1997-2002年（47%）。从1995年11月开始，72名患者接受了高效抗逆转录病毒疗法治疗。然而，到2002年12月，只有52.5%和83%的HAART治疗患者分别有稳定的病毒血症（< 400拷贝/ml）和足够的CD 4（+）T细胞计数（> 200/μ l）。这些数据表明，肝脏相关的死亡率在1991 - 1996年达到峰值，但随后趋于下降。此外，尽管广泛使用高效抗逆转录病毒疗法治疗患者，但到2002年底，仍有相当一部分人的免疫和病毒学状况不令人满意。(c)2004年，英国传染病学会。由爱思唯尔有限公司出版。保留所有权利。
Objective. To determine the disease progression of HIV-HCV co-infected hemophitiacs in a large cohort of patients(n = 288) cared for at a single medical institution. Patients and methods. Annual mortality rates for AIDS- and liver-related death were calculated and Kaplan-Meier survival plots were drawn to determine the progression to AIDS and death.Results. Between January 1985 and December 2002, 179 (62.2%) and 195 (67.7%) of these patients had developed AIDS or died, respectively. Overall, AIDS accounted for 128 deaths, which almost entirely (93.7%) occurred prior to the introduction of highly active antiretroviral therapy (HAART) at the end of 1995. A total of 29 patients died of liver failure, most of them (69%) during the years 1991 -1996. Since 1997, only five cases of fatal liver failure were reported. Non-HIV-HCV related reasons were responsible for 38 deaths and occurred predominantly (47%) in the years 1997-2002. Starting November 1995, 72 patients were treated with HAART. However, by December 2002, only 52.5% and 83% of all HAART-treated patients had a stable viremia (< 400 copies/ml) and a sufficient CD4(+) T-cell count (> 200/ mu l), respectively.Conclusion. These data indicate that liver-related mortality peaked in the years 1991 1996, but subsequently tended to decline. Moreover, despite widespread treatment of patients with HAART, a significant proportion of individuals had an unsatisfactory immunological and virological status at the end of 2002. (c) 2004 The British Infection Society. Published by Elsevier Ltd. All rights reserved.