Manavi K, Dhasmana D, Cramb R
Department of GUM, Selly Oak Hospital, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK.
Int J STD AIDS. 2012 Aug;23(8):e4-6. doi: 10.1258/ijsa.2009.009386.
To investigate the prevalence of syphilitic hepatitis among a group of HIV-infected patients we performed a cross-sectional observational study of consecutive HIV-infected patients with early syphilis attending University Hospital Birmingham between 1 January 2005 and 31 August 2008. The AIDS Clinical Trials Group grading for abnormal liver enzymes was used to identify hepatitis. A total of 62 HIV-infected patients were diagnosed with early syphilis during the study period. Twelve (19.3%) of them demonstrated abnormal liver enzymes consistent with syphilitic hepatitis involving raised levels of alanine aminotransferase, aspartate transaminase, alkaline phosphatase or gamma-glutamyl transferase (GGT). Grade 3 hepatotoxicity was observed among five patients. None of the patients with syphilitic hepatitis had grade IV hepatitis or abnormal bilirubin levels. Liver biopsy was not carried out in any of the patients, and following completion of treatment of syphilis all abnormal liver enzymes returned to normal levels after a median of 16 weeks. Exclusion of syphilis must be considered when investigating hepatic disease in HIV-infected patients.
为调查一组HIV感染患者中梅毒相关性肝炎的患病率，我们对2005年1月1日至2008年8月31日期间在伯明翰大学医院就诊的连续早期梅毒HIV感染患者进行了一项横断面观察性研究。采用艾滋病临床试验组对肝酶异常的分级来确定肝炎。在研究期间，共有62例HIV感染患者被诊断为早期梅毒。其中12例（19.3%）表现出与梅毒相关性肝炎一致的肝酶异常，包括丙氨酸氨基转移酶、天冬氨酸氨基转移酶、碱性磷酸酶或γ-谷氨酰转移酶（GGT）水平升高。5例患者观察到3级肝毒性。梅毒相关性肝炎患者均无IV级肝炎或胆红素水平异常。所有患者均未进行肝活检，梅毒治疗结束后，所有异常肝酶在中位时间16周后恢复正常水平。在调查HIV感染患者的肝脏疾病时，必须考虑排除梅毒。
