Increasing mortality due to end-stage liver disease in patients with human immunodeficiency virus infection
Increasing mortality due to end-stage liver disease in patients with human immunodeficiency virus infection
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DOI：
10.1086/318501
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发表时间：
2001-02-01
影响因子：
11.8
通讯作者：
Snydman, DR
中科院分区：
文献类型：
--
作者：
Bica, I;McGovern, B;Snydman, DR
高效抗逆转录病毒治疗降低了人类免疫缺陷病毒（HIV）相关的死亡率;其他合并症，如慢性肝病，正在发挥更大的作用。我们回顾性研究了1991年，1996年和1998-1999年在我们的机构艾滋病毒血清阳性患者的死亡原因。1998-1999年，22例死亡中有11例（50%）是由于终末期肝病，而1991年26例死亡中有3例（11.5%），1996年36例死亡中有5例（13.9%）（P = 0.003）。在1998-1999年，55%的患者在死亡前一年内的血浆HIV RNA水平和/或CD 4细胞计数>200个/mm 3。大多数接受检测的患者可检测到丙型肝炎病毒抗体（1991年死亡的患者中有75%，1996年死亡的患者中有57.7%，1998-1999年死亡的患者中有93.8%; P = NS）。1998-1999年，7名病人（31.8%）因肝毒性而停止抗逆转录病毒疗法，而1991年为0名，1996年为2名（5.6%）。终末期肝病现在是我们住院的HIV血清阳性人群的主要死亡原因。
Highly active antiretroviral therapy has decreased human immunodeficiency virus (HIV)-associated mortality; other comorbidities, such as chronic liver disease, are assuming greater importance. We retrospectively examined the causes of death of HIV-seropositive patients at our institution in 1991, 1996, and 1998-1999. In 1998-1999, 11 (50%) of 22 deaths were due to end-stage liver disease, compared with 3 (11.5%) of 26 in 1991 and 5 (13.9%) of 36 in 1996 (P = .003). In 1998-1999, 55% of patients had nondetectable plasma HIV RNA levels and/or CD4 cell counts of >200 cells/mm(3) within the year before death. Most of the patients that were tested had detectable antibodies to hepatitis C virus (75% of patients who died in 1991, 57.7% who died in 1996, and 93.8% who died in 1998-1999; P = NS). In 1998-1999, 7 patients (31.8%) discontinued antiretroviral therapy because of hepatotoxicity, compared with 0 in 1991 and 2 (5.6%) in 1996. End-stage liver disease is now the leading cause of death in our hospitalized HIV-seropositive population.