Analysis of the Hepatic Functional Reserve, Portal Hypertension, and Prognosis of Patients With Human Immunodeficiency Virus/Hepatitis C Virus Coinfection Through Contaminated Blood Products in Japan

作者：Eguchi S^*; Takatsuki M; Soyama A; Hidaka M; Nakao K; Shirasaka T; Yamamoto M; Tachikawa N; Gatanaga H; Kugiyanna Y; Yatsuhashi H; Chide T; Kokudo N

来源：Transplantation Proceedings, 2014, 46(3): 736-738.

DOI：10.1016/j.transproceed.2013.11.126

Background. As the survival of human immunodeficiency virus (HIV)-infected individuals has improved due to the widespread use of antiretroviral therapy, the mortality rate due to hepatitis C virus (HCV)-related liver disease has increased in HIV/HCV-coinfected patients. %26lt;br%26gt;Aim. The aims of this study were to establish the appropriate therapeutic strategy for HIV/HCV-coinfected patients by evaluating the liver function, including the hepatic functional reserve and portal hypertension, and to investigate the prognosis of HIV/HCV-coinfected patients in Japan. %26lt;br%26gt;Patients and Methods. In addition to regular liver function tests, the hepatic functional reserve of 41 patients with HIV/HCV coinfection was evaluated using the indocyanine green retention rate and liver galactosyl serum albumin-scintigraphy. The data for 146 patients with HIV/HCV coinfection through blood products were extracted from 4 major HIV centers in Japan. In addition to liver function tests, the platelet counts (PLT) were evaluated as a marker of portal hypertension. %26lt;br%26gt;Results. In spite of the relatively preserved general liver function test results, approximately 40% of the HIV/HCV-coinfected patients had an impaired hepatic functional reserve. In addition, while the albumin and bilirubin levels were normal, the PLT was %26lt;150,000/mu L in 17 patients. Compared with HCV mono-infected patients with a PLT %26lt;150,000/mu L, the survival of HIV/HCV-coinfected patients was shorter (HCV, 5 years, 97%; 10 years, 86% and HIV/HCV, 5 years, 87%; 10 years, 73%; P %26lt; .05). %26lt;br%26gt;Conclusion. These results must be taken into account to establish an optimal therapeutic strategy, including the appropriate timing of liver transplantation in HIV/HCV-coinfected patients in Japan.

• 出版日期2014-4