Liver-related mortality in human-immunodeficiency-virus-infected patients between 1995 and 2003 in the French GERMIVIC Joint Study Group Network (MORTAVIC 2003 Study)
Liver-related mortality in human-immunodeficiency-virus-infected patients between 1995 and 2003 in the French GERMIVIC Joint Study Group Network (MORTAVIC 2003 Study)
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DOI：
10.1111/j.1365-2893.2006.00791.x
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发表时间：
2007-03-01
影响因子：
2.5
通讯作者：
Cacoub, P.
中科院分区：
文献类型：
--
作者：
Rosenthal, E.;Pialoux, G.;Cacoub, P.
本研究的目的是确定在全国范围内的HIV感染患者中，在引入高效抗逆转录病毒治疗（HAART）7年后，终末期肝病（ESLD）的死亡率。GERMIVIC研究小组的所有内科和传染病部门前瞻性地记录了2003年期间艾滋病毒感染患者的所有死亡。59个部门，共20 940名艾滋病毒感染者，参加了这项研究。调查结果与1995年、1997年和2001年采用类似方法进行的调查结果进行了比较。在2003年观察到的215例死亡中，101例（46.9%）与艾滋病有关，27例（12.6%）与晚期肝病有关，87例（40.5%）与其他原因有关。ESLD的死亡率占非艾滋病相关死亡的23.7%。死于ESLD的患者中，92.6%的患者因丙型肝炎病毒（HCV）和中度（30-60 g）或高度（> 60 g）饮酒（分别为43.5%和26.0%）而患有慢性肝炎。在这一人群中，1995年因ESLD死亡的比例为1.5%，1997年为6.6%，2001年为14.3%，2003年为12.6%。2003年肝细胞癌作为死亡原因的患病率仍然很高，但与2001年相比保持稳定（25%对14.8%）。2003年死于ESLD的患者中，丙型肝炎治疗的频率（44.4%）高于2001年（26.3%）。HAART引入7年后，与HCV感染相关的ESLD是HIV感染患者死亡的主要原因，在2001年至2003年期间没有增加。
The objective of the present study was to determine mortality because of end-stage liver disease (ESLD) in a nationwide population of HIV-infected patients, 7 years following the introduction of highly active antiretroviral therapy (HAART). All departments of internal medicine and infectious diseases from the GERMIVIC Study Group prospectively recorded all deaths in HIV-infected patients during 2003. Fifty-nine departments, following a total of 20 940 HIV-infected patients, participated in the study. Results were compared with those of previous surveys conducted using similar methodology in 1995, 1997 and 2001. Among 215 deaths observed during 2003, 101 (46.9%) were related to AIDS, 27 (12.6%) to ESLD and 87 (40.5%) to other causes. Mortality because of ESLD represented 23.7% of non-AIDS-related deaths. Patients dying from ESLD had chronic hepatitis because of hepatitis C virus (HCV) in 92.6% of cases and moderate (30-60 g) or high (> 60 g) alcohol consumption (43.5% and 26.0%, respectively). In this population, deaths because of ESLD were 1.5% in 1995, 6.6% in 1997, 14.3% in 2001 and 12.6% in 2003. The prevalence of hepatocellular carcinoma as a cause of death remained high in 2003 but stable when compared with 2001 (25%vs 14.8%). Treatment of hepatitis C in patients who died from ESLD was more frequent in 2003 (44.4%) than in 2001 (26.3%). Seven years after the introduction of HAART, ESLD associated with HCV infections is a leading cause of mortality in HIV-infected patients, which did not increase between the years 2001 and 2003.