【medical-news】【资讯翻译】HIV患者即使正接受治疗仍可增加丙型肝炎的发生
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http://www.medpagetoday.com/MeetingCoverage/IAC/33941
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WASHINGTON – People with both HIV and hepatitis C (HCV) are at increased risk for hepatic decompensation – even if they are on effective antiretroviral therapy -- compared with people who have only the liver disease, a researcher reported here.
In a large retrospective cohort, those with both viruses had a 6.3% rate of decompensation compared with 5% for those with just HCV (HR 1.83, 95% CI 1.54 to 2.18, P=0.004).
Their risk of liver cancer and death was also markedly higher, according to Vincent Lo Re, MD, of the University of Pennsylvania in Philadelphia.
Fibrosis, anemia, and race were factors that affected the risk of decompensation among those with both viruses, Lo Re reported at the International AIDS Conference.
The findings come from an analysis of outcomes for more than 10,000 patients in the Veterans Aging Cohort Study, including 4,280 with both viruses and 6,079 with just HCV, Lo Re told attendees at an oral session.
All patients in the cohort had HCV viremia but had not been treated for the virus. Those with both viruses were newly on HIV therapy but had been on combination treatment for at least a year.
The researchers defined hepatic decompensation events as diagnoses of ascites, spontaneous bacterial peritonitis, and variceal hemorrhage. They also evaluated the risk of hepatocellular carcinoma and death as a secondary outcome.
Among the coinfected patients, 1.2% developed hepatocellular carcinoma, compared with 0.9% of those with HCV alone, (HR 1.69, 95% CI1.13 to 2.52).
The rate of death among coinfected patients was 32.9%, compared with 15.4%, a difference that was significant at P<0.001. But the rate of liver deaths – as a percentage of all deaths – was lower in coinfected patients: 7.8% versus 20.1%.
Among patients who decompensated, Lo Re reported, mortality was higher in coinfected patients, at 75.2% versus 56.8%, and was significant at P<0.001.
Nonblack race, baseline fibrosis greater than 3.25, and baseline hemoglobin less than 10 grams per deciliter were also associated with a higher risk of decompensation among patients with both viruses.
Lo Re cautioned that the analysis might have missed some outcomes, including liver deaths outside the VA. And, he noted, duration and stage of HCV were not measured.
The study underscores the need for HCV treatment, commented John Ward, MD, director of the CDC's Division of Hepatitis Prevention.
"HIV treatment alone is not enough," he told MedPage Today. "You have to do more to protect the liver."
HIV, he noted, is well known to accelerate the progression of HCV but the study may have been overtaken by events, he said.
In the past many people with HCV died before getting any treatment for the virus – something that would be deemed unacceptable in connection with HIV -- but recent advances in medications have increased the therapeutic options for hepatitis.
Those options "are going to expand fairly quickly in the fairly near future so we can treat not just the co-factors (such as HIV) but also the actual primary infection that's causing the liver disease," he said.
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请根据自己的专业背景选择相应的资讯认领，经常认领而不能及时提供优质稿件者将被列入黑名单，取消认领资格，请大家注意！
新近参与本次活动的会员请查看 【公告】动态版重启资讯翻译计划：我为人人，人人为我，共同提高
寻找最近的翻译贴请查看 http://search.dxy.cn/?words=%E8%B5%84%E8%AE%AF%E7%BF%BB%E8%AF%91&bid=116&t=1&c=1&age=7&bid=116&limit=30&o=1
翻译时请参照版规 【版务】科技动态版版规及加分细则（ 2014-02-21 更新）
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WASHINGTON – People with both HIV and hepatitis C (HCV) are at increased risk for hepatic decompensation – even if they are on effective antiretroviral therapy -- compared with people who have only the liver disease, a researcher reported here.
In a large retrospective cohort, those with both viruses had a 6.3% rate of decompensation compared with 5% for those with just HCV (HR 1.83, 95% CI 1.54 to 2.18, P=0.004).
Their risk of liver cancer and death was also markedly higher, according to Vincent Lo Re, MD, of the University of Pennsylvania in Philadelphia.
Fibrosis, anemia, and race were factors that affected the risk of decompensation among those with both viruses, Lo Re reported at the International AIDS Conference.
The findings come from an analysis of outcomes for more than 10,000 patients in the Veterans Aging Cohort Study, including 4,280 with both viruses and 6,079 with just HCV, Lo Re told attendees at an oral session.
All patients in the cohort had HCV viremia but had not been treated for the virus. Those with both viruses were newly on HIV therapy but had been on combination treatment for at least a year.
The researchers defined hepatic decompensation events as diagnoses of ascites, spontaneous bacterial peritonitis, and variceal hemorrhage. They also evaluated the risk of hepatocellular carcinoma and death as a secondary outcome.
Among the coinfected patients, 1.2% developed hepatocellular carcinoma, compared with 0.9% of those with HCV alone, (HR 1.69, 95% CI1.13 to 2.52).
The rate of death among coinfected patients was 32.9%, compared with 15.4%, a difference that was significant at P<0.001. But the rate of liver deaths – as a percentage of all deaths – was lower in coinfected patients: 7.8% versus 20.1%.
Among patients who decompensated, Lo Re reported, mortality was higher in coinfected patients, at 75.2% versus 56.8%, and was significant at P<0.001.
Nonblack race, baseline fibrosis greater than 3.25, and baseline hemoglobin less than 10 grams per deciliter were also associated with a higher risk of decompensation among patients with both viruses.
Lo Re cautioned that the analysis might have missed some outcomes, including liver deaths outside the VA. And, he noted, duration and stage of HCV were not measured.
The study underscores the need for HCV treatment, commented John Ward, MD, director of the CDC's Division of Hepatitis Prevention.
"HIV treatment alone is not enough," he told MedPage Today. "You have to do more to protect the liver."
HIV, he noted, is well known to accelerate the progression of HCV but the study may have been overtaken by events, he said.
In the past many people with HCV died before getting any treatment for the virus – something that would be deemed unacceptable in connection with HIV -- but recent advances in medications have increased the therapeutic options for hepatitis.
Those options "are going to expand fairly quickly in the fairly near future so we can treat not just the co-factors (such as HIV) but also the actual primary infection that's causing the liver disease," he said.
