Miller M, Kahraman A, Ross B, Beste M, Gerken Guido
Department of Gastroenterology and Hepatology, University Hospital Essen, Hufelandstr. 55, 45122 Essen, Germany.
Eur J Med Res. 2009 Sep 1;14(9):369-77. doi: 10.1186/2047-783x-14-9-369.
Quantitative tests of liver function (QTLF) which are based on the hepatic metabolism or clearance of test substances have been successfully used to predict prognosis of a variety of different liver diseases. Still sufficient data in HIV-patients under anti-retroviral therapy (ART) are lacking. Therefore, the aim of this prospective study was to investigate if and to what extent ART influences a broad panel of quantitative tests of liver function in patients with HIV-infection.
Nineteen patients (14 males, 5 females, mean age 40 years) with HIV-infection underwent QTLF including lidocaine half-life test (LHT), galactose elimination capacity (GEC), and indocyanine green clearance (IGC). These tests were performed before and 3 to 6 months after initiation of anti-retroviral therapy. Twenty age-matched healthy, medication- and virus-free adults served as controls.
Lidocaine half-life was significantly lower in HIV-patients without ART. Combining anti-retroviral therapies shifted cytochrome p450 activity back into standard ranges. Galactose elimination capacity as a parameter of cytosolic liver function and indocyanine green clearance as a parameter of liver perfusion were not affected by ART.
QTLF may be a tool to predict prognosis or hepatic complications in HIV-infected patients with liver disease. Early determination of lidocaine half-life seems to be useful - this should be considered during the treatment of HIV-positive individuals.
基于受试物质肝脏代谢或清除率的肝功能定量检测（QTLF）已成功用于预测多种不同肝脏疾病的预后。然而，接受抗逆转录病毒治疗（ART）的HIV患者仍缺乏足够的数据。因此，这项前瞻性研究的目的是调查ART是否以及在多大程度上影响HIV感染患者的一系列肝功能定量检测。
19例HIV感染患者（14例男性，5例女性，平均年龄40岁）接受了QTLF检测，包括利多卡因半衰期试验（LHT）、半乳糖清除能力（GEC）和吲哚菁绿清除率（IGC）。这些检测在开始抗逆转录病毒治疗前以及治疗后3至6个月进行。20名年龄匹配的健康、未用药且无病毒的成年人作为对照。
未接受ART的HIV患者利多卡因半衰期显著降低。联合抗逆转录病毒疗法使细胞色素p450活性恢复到标准范围。作为胞质肝功能参数的半乳糖清除能力和作为肝脏灌注参数的吲哚菁绿清除率不受ART影响。
QTLF可能是预测HIV感染肝病患者预后或肝脏并发症的一种工具。早期测定利多卡因半衰期似乎有用——在治疗HIV阳性个体时应予以考虑。
