Center for Liver Diseases and Department of Medicine, Inova Fairfax Hospital, Falls Church, VA, USA.
Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, USA.
Ann Hepatol. 2013;13(1):60-4.
INTRODUCTION. Chronic liver disease (CLD) is becoming a major cause of mortality in patients who are positive with human immunodeficiency virus (HIV). Our aim was to assess the prevalence of CLD in HIV+ individuals. MATERIAL AND METHODS. We utilized the National Health and Nutrition Examination Survey (1999-2008) to assess the association of CLD with HIV infection. In eligible participants (18-49 years), HIV infection was defined as positive anti-HIV by enzyme immunoassay further confirmed by Western blot. The diagnosis of CLD included chronic hepatitis C (CH-C), alcohol-related liver disease (ALD) and non-alcoholic fatty liver disease (NAFLD). Clinic-demographic and laboratory parameters were used to assess differences between those with and without HIV infection. RESULTS. 14,685 adults were included. Of those, 0.43 ± 0.08% were HIV-positive and 13.8% had evidence of CLD, including 26.3% in HIV-positive individuals and 13.7% in HIV-negative controls (p = 0.0341). In the U.S. population, independent predictors of CLD included HIV positivity [OR = 1.96 (1.02-3.77), p = 0.04], older age [OR = 1.03 (1.02-1.03), p < 0.0001], male gender [OR = 2.15 (1.89-2.44), p < 0.0001] and obesity [OR = 2.10 (1.82-2.43), p < 0.0001], while African American race/ethnicity was associated with lower risk for CLD [OR = 0.68 (0.58-0.80), p < 0.0001]. CONCLUSIONS. CLD is common in HIV positive individuals. With successful long term treatment of HIV, management of CLD will continue to remain very important in these patients.
慢性肝病（CLD）在人类免疫缺陷病毒（HIV）阳性患者中是一个主要的死亡原因。我们的目的是评估 HIV 阳性个体中 CLD 的患病率。
我们利用国家健康和营养检查调查（1999-2008 年）来评估 CLD 与 HIV 感染之间的关系。在合格的参与者（18-49 岁）中，HIV 感染被定义为酶免疫测定阳性，进一步通过 Western blot 确认。CLD 的诊断包括慢性丙型肝炎（CH-C）、酒精性肝病（ALD）和非酒精性脂肪性肝病（NAFLD）。临床-人口统计学和实验室参数用于评估 HIV 感染患者和无 HIV 感染患者之间的差异。
共纳入 14685 名成年人。其中，0.43%±0.08%为 HIV 阳性，13.8%有 CLD 证据，包括 HIV 阳性患者中 26.3%和 HIV 阴性对照者中 13.7%（p=0.0341）。在美国人群中，CLD 的独立预测因素包括 HIV 阳性[比值比（OR）=1.96（1.02-3.77），p=0.04]、年龄较大[OR=1.03（1.02-1.03），p<0.0001]、男性[OR=2.15（1.89-2.44），p<0.0001]和肥胖[OR=2.10（1.82-2.43），p<0.0001]，而非裔美国人种族/民族与 CLD 风险降低相关[OR=0.68（0.58-0.80），p<0.0001]。
CLD 在 HIV 阳性个体中很常见。随着 HIV 的长期成功治疗，这些患者 CLD 的管理将继续非常重要。
