在接受高效抗逆转录病毒治疗（HAART）期间，低水平的肝酶升高与HIV/HCV合并感染患者的肝纤维化进展无关。

Low-level liver enzyme elevations during HAART are not associated with liver fibrosis progression among HIV/HCV-coinfected patients.

作者信息

Vergara Salvador, Macías Juan, Mira José A, García-García José A, Merchante Nicolás, del Valle José, Abdel-Kader Laila, Lozano Fernando, Gómez-Mateos Jesús M, Pineda Juan A

机构信息

Unidad de Enfermedades Infecciosas, Hospital Universitario de Valme, Seville, Spain.

出版信息

J Antimicrob Chemother. 2007 Jan;59(1):87-91. doi: 10.1093/jac/dkl447. Epub 2006 Nov 9.

DOI:10.1093/jac/dkl447

PMID:17095528

Abstract

OBJECTIVES

To assess the association between non-severe liver enzyme elevations (LEEs) during antiretroviral treatment and liver fibrosis in HIV/HCV-coinfected patients.

METHODS

All co-infected patients from an Infectious Disease Unit who had received treatment with highly active antiretroviral therapy (HAART) for at least 12 months before undergoing a liver biopsy were included in the study.

RESULTS

One-hundred and sixteen patients met the inclusion criteria of the study. Advanced liver fibrosis was observed in 32 (38%) of 84 patients who developed non-severe LEEs and in 11 (34%) of 32 subjects who developed severe (grade > or = 3) LEEs, (P = 0.7). Seven (6%) of 116 patients showed grade 3 or 4 LEEs for at least 30% of the follow-up. Advanced liver fibrosis was observed in five (71%) of these patients and in 38 (35%) of the 109 subjects who did not develop long-term severe LEEs (P = 0.05). Eight (10%) of 84 patients showed grade 2 LEEs for at least 30% of the follow-up. Advanced liver fibrosis was observed in 28 (37%) of 76 subjects who did not develop long-term grade 2 LEEs and in three (38%) of eight patients who developed them (P = 0.9).

CONCLUSIONS

In HIV/HCV-coinfected patients, non-severe LEEs, whether persistent or not, are not associated with advanced liver fibrosis. On the other hand, long-term severe LEEs are associated with more severe liver fibrosis in this population.

摘要

目的

评估抗逆转录病毒治疗期间非严重肝酶升高（LEEs）与HIV/HCV合并感染患者肝纤维化之间的关联。

方法

本研究纳入了传染病科所有在接受肝活检前至少接受过12个月高效抗逆转录病毒治疗（HAART）的合并感染患者。

结果

116例患者符合研究纳入标准。在84例出现非严重LEEs的患者中，32例（38%）观察到晚期肝纤维化；在32例出现严重（≥3级）LEEs的患者中，11例（34%）观察到晚期肝纤维化，（P = 0.7）。116例患者中有7例（6%）在至少30%的随访期内出现3级或4级LEEs。这些患者中有5例（71%）观察到晚期肝纤维化，而在109例未出现长期严重LEEs的患者中有38例（35%）观察到晚期肝纤维化（P = 0.05）。84例患者中有8例（10%）在至少30%的随访期内出现2级LEEs。在76例未出现长期2级LEEs的患者中，28例（37%）观察到晚期肝纤维化；在8例出现长期2级LEEs的患者中，3例（38%）观察到晚期肝纤维化（P = 0.9）。