乙型肝炎和丙型肝炎感染以及人类免疫缺陷病毒感染者的肝病趋势。
Hepatitis B and C infection and liver disease trends among human immunodeficiency virus-infected individuals.
机构信息
Public Health-Seattle and King County, WA 98104, United States.
出版信息
World J Gastroenterol. 2011 Apr 14;17(14):1807-16. doi: 10.3748/wjg.v17.i14.1807.
AIM
To examine trends in and correlates of liver disease and viral hepatitis in an human immunodeficiency virus (HIV)-infected cohort.
METHODS
The multi-site adult/adolescent spectrum of HIV-related diseases (ASD) followed 29 490 HIV-infected individuals receiving medical care in 11 U.S. metropolitan areas for an average of 2.4 years, and a total of 69 487 person-years, between 1998 and 2004. ASD collected data on the presentation, treatment, and outcomes of HIV, including liver disease, hepatitis screening, and hepatitis diagnoses.
RESULTS
Incident liver disease, chronic hepatitis B virus (HBV), and hepatitis C virus (HCV) were diagnosed in 0.9, 1.8, and 4.7 per 100 person-years. HBV and HCV screening increased from fewer than 20% to over 60% during this period of observation (P < 0.001). Deaths occurred in 57% of those diagnosed with liver disease relative to 15% overall (P < 0.001). Overall 10% of deaths occurred among individuals with a diagnosis of liver disease. Despite care guidelines promoting screening and vaccination for HBV and screening for HCV, screening and vaccination were not universally conducted or, if conducted, not documented.
CONCLUSION
Due to high rates of incident liver disease, viral hepatitis screening, vaccination, and treatment among HIV-infected individuals should be a priority.
目的
在人类免疫缺陷病毒（HIV）感染队列中，检查肝脏疾病和病毒性肝炎的趋势及其相关因素。
方法
多地点成人/青少年 HIV 相关疾病谱（ASD）在 1998 年至 2004 年期间，对 11 个美国大都市地区接受医疗护理的 29490 名 HIV 感染者进行了平均 2.4 年的随访，共随访 69487 人年，ASD 收集了 HIV 的发病、治疗和结局的数据，包括肝脏疾病、肝炎筛查和肝炎诊断。
结果
每 100 人年发生 0.9 例、1.8 例和 4.7 例新发肝脏疾病、慢性乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）。在此观察期间，HBV 和 HCV 筛查率从不到 20%增加到 60%以上（P < 0.001）。与总体 15%的死亡率相比，诊断为肝脏疾病的患者中有 57%死亡（P < 0.001）。总体上，10%的死亡发生在有肝脏疾病诊断的患者中。尽管有针对 HBV 的筛查、疫苗接种和 HCV 筛查的护理指南，但并未普遍进行筛查和疫苗接种，或者如果进行了筛查和疫苗接种，也没有记录。
结论
由于 HIV 感染者新发肝脏疾病、病毒性肝炎的筛查、疫苗接种和治疗的发生率较高，应将其作为优先事项。
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