Buckley J A, Hutchins G M
Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
Mod Pathol. 1995 May;8(4):398-401.
Observation of a patient with the acquired immunodeficiency syndrome and veno-occlusive disease (VOD) at autopsy prompted us to review the liver pathology of autopsied patients with human immunodeficiency virus seropositivity and/or acquired immunodeficiency syndrome (HIV/AIDS) to determine the frequency of occurrence of VOD and the circumstances in which it arose.
the patients studied had been autopsied at The Johns Hopkins Hospital, a referral center, between April 1981 and July 1993. We reviewed 275 adult HIV/AIDS patients autopsied with liver slides available for evaluation. Twenty cases fulfilled the pathologic criteria for VOD, central vein obliteration and sclerosis, sinusoidal congestion and fibrosis, and perivenular hepatocellular degeneration and necrosis. The autopsy cases were compared for age, race, gender, duration of HIV infection, and risk factor for the acquisition of HIV infection. The clinical and pathologic features of the 20 cases with VOD were reviewed.
of the 275 HIV/AIDS patients, 20 (7.3%) had VOD. The average age was 41 yr (range 30-58) and most cases were black males (15 black, 5 white, and 18 male). The duration of HIV infection ranged from 6 mo to 8 yr (mean, 19 mo). The risk factor for acquiring HIV infection was primarily intravenous drug abuse (12 of 20, 60%). Six patients had homosexual or bisexual contacts, and two had other or unknown risk factors. In contrast, among the total of 275 HIV/AIDS autopsied patients reviewed, only 72 (26%) reported intravenous drug abuse whereas 157 (57%) individuals listed homosexual or bisexual contacts as a risk for developing HIV infection. Forty-six patients (17%) had other or unknown means of HIV infection. Statistical analysis by risk factor showed that intravenous drug abuse was statistically significant as a predictor for the development of VOD in an HIV/AIDS patient (P < 0.005).
VOD of the liver can be seen in patients with HIV/AIDS and is associated with intravenous drug abuse.
对一名获得性免疫缺陷综合征合并肝静脉闭塞病（VOD）患者进行尸检观察后，我们回顾了人类免疫缺陷病毒血清学阳性和/或获得性免疫缺陷综合征（HIV/AIDS）患者的肝脏病理学情况，以确定VOD的发生率及其发生的相关情况。
研究对象为1981年4月至1993年7月间在转诊中心约翰·霍普金斯医院接受尸检的患者。我们回顾了275例有肝脏切片可供评估的成年HIV/AIDS尸检患者。20例符合VOD的病理标准，即中央静脉闭塞和硬化、窦状隙充血和纤维化以及小叶中央肝细胞变性和坏死。对尸检病例的年龄、种族、性别、HIV感染持续时间以及感染HIV的危险因素进行了比较。对20例VOD患者的临床和病理特征进行了回顾。
275例HIV/AIDS患者中，20例（7.3%）发生了VOD。平均年龄为41岁（范围30 - 58岁），大多数病例为黑人男性（15例黑人，5例白人，18例男性）。HIV感染持续时间为6个月至8年（平均19个月）。感染HIV的主要危险因素是静脉注射毒品（20例中有12例，占60%）。6例有同性恋或双性恋接触史，2例有其他或不明危险因素。相比之下，在总共275例接受回顾的HIV/AIDS尸检患者中，只有72例（26%）报告有静脉注射毒品史，而157例（57%）将同性恋或双性恋接触列为感染HIV的危险因素。46例患者（17%）有其他或不明的HIV感染途径。按危险因素进行的统计分析表明，静脉注射毒品作为HIV/AIDS患者发生VOD的预测因素具有统计学意义（P < 0.005）。
HIV/AIDS患者可出现肝脏VOD，且与静脉注射毒品有关。
