Ramos Paesa C, Arazo Garcés P, Pascual Catalán A, Hermida Lazcano I, Aguirre Errasti J M
Servicio de Medicina Interna, Hospital Miguel Servet, Zaragoza.
Rev Clin Esp. 1998 Apr;198(4):207-11.
To know the characteristics of chronic hepatitis C in HIV-infected patients and whether there are differences compared with HIV-negative patients, in order to obtain orientative helpful data for the diagnostic-therapeutic decision making, a usually difficult issue in these patients.
Sixty patients with criteria of chronic hepatitis C virus (HCV) criteria were studied. Thirty-three of these patients were coinfected with HIV. The possible associations between the degree of histologic damage and several variables wee studied: age, estimated time of evolution of HCV infection, transaminases, gammaglobulins, GGT, and alcohol consumption. On the other hand, the possible differences regarding the histologic hepatic aggression were assessed. An attempt was made to know whether HIV could negatively influence the evolution of chronic hepatitis C.
A direct relationship was observed between hepatic damage, HAI and levels of GOT, GPT, GGT (p < 0.005), and gammaglobulins (p < 0.01). The degree of hepatic fibrosis was directly correlated with the GGT level (mild fibrosis: 47 +/- 34 U/l; severe fibrosis: 86 +/- 60 U/l) (p < 0.05) and the estimated evolution time of infection (p < 0.05). Alcohol consumption was associated with the fibrosis degree (p < 0.01). The degree of histologic damage was similar in the HIV-positive group (HAI: 8.3 +/- 3.6) and HIV-negative patients (HAI: 7.2 +/- 2.8), although the degree of lobular involvement was higher in HIV-positive patients (p < 0.05).
Patients with chronic hepatitis C and infected with HIV did not have a higher degree of hepatic damage than HIV-negative patients. GOT, GPT, and gamma globulin levels, as well as a longer evolution time of HCV infection were associated with a higher degree of hepatic histologic activity. Alcohol consumption seemed to be associated with a poorer course of the liver disease in these patients.
了解人类免疫缺陷病毒（HIV）感染患者慢性丙型肝炎的特征，以及与HIV阴性患者相比是否存在差异，以便获取有助于诊断治疗决策的定向性有用数据，这在这些患者中通常是个难题。
研究了60例符合慢性丙型肝炎病毒（HCV）标准的患者。其中33例患者合并感染HIV。研究了组织学损伤程度与几个变量之间可能的关联：年龄、HCV感染估计病程、转氨酶、γ球蛋白、γ-谷氨酰转移酶（GGT）和饮酒情况。另一方面，评估了组织学肝侵袭方面可能存在的差异。试图了解HIV是否会对慢性丙型肝炎的病程产生负面影响。
观察到肝损伤、肝活动指数（HAI）与谷草转氨酶（GOT）、谷丙转氨酶（GPT）、GGT水平（p<0.005）以及γ球蛋白水平（p<0.01）之间存在直接关系。肝纤维化程度与GGT水平（轻度纤维化：47±34 U/L；重度纤维化：86±60 U/L）（p<0.05）以及感染估计病程（p<0.05）直接相关。饮酒与纤维化程度相关（p<0.01）。HIV阳性组（HAI：8.3±3.6）和HIV阴性患者（HAI：7.2±2.8）的组织学损伤程度相似，尽管HIV阳性患者的小叶受累程度更高（p<0.05）。
合并感染HIV的慢性丙型肝炎患者的肝损伤程度并不高于HIV阴性患者。GOT、GPT和γ球蛋白水平，以及HCV感染病程较长与更高程度的肝组织学活性相关。饮酒似乎与这些患者肝病的较差病程相关。
