HIV合并HCV抗病毒治疗新进展北京丙肝医院-培训课件.pptVIP

* * 总结 HIV合并HBV和HCV非常普遍，HBV/HCV能够加重HIV的进展，并可能影响ART疗效，对这些患者应同时考虑保护肝脏功能和治疗HIV感染 性传播已经成为我国HIV传播的主要途径，是我国全面控制HIV/AIDS的关键，最新的数据显示，早期干预能使单阳伴侣的HIV传播风险降低96% HIV/HCV合并感染增加死亡率 HIV 加重 HCV 疾病: 导致持续的HCV病毒血症 ? 终末期肝病 (肝纤维化 肝硬化) ? 肝细胞癌 加速肝纤维化进程: ~20 vs 30 年 炎症加重(vs HCV alone) 肝外表现加重 HCV 加重HIV 进程: ? HIV抗病毒治疗药物的肝毒性 加速HIV疾病进程 * Sulkowski MS. J Hepatol. 2008;48:353-367. Gebo KA, et al. J Acquir Immune Defic Syndr. 2003;34:165-173. Weber R, et al. Arch Intern Med. 2006;166:1632-1641. 谢谢聆听！ * Reference: Salmon-Ceron D et al. Liver disease as a major cause of death among HIV infected patients: role of hepatitis C and B viruses and alcohol. J Hepatol. 2005;42:799-805. In a French study of 822 HIV-infected patients, 29% were coinfected with HCV. Among the HIV/HCV coinfected group, the most frequent causes of death were end-stage liver disease (31%) and AIDS (29%). Reference Salmon-Ceron D, Lewden C, Morlat P, et al. Liver disease as a major cause of death among HIV infected patients: role of hepatitis C and B viruses and alcohol. J Hepatol. 2005;42:799-805. Slide 3 – Disease progression in hepatitis C: person-to-person variability The course of HCV infection varies widely between individuals. Various factors influence the rate of progression. Female sex and young age at the time of infection are factors that decrease the risk of disease progression. In contrast, alcohol use and co-infection with HIV or hepatitis B virus increase the risk of disease progression.1 An acute symptomatic phase of liver inflammation may occur 15-50 days after infection, but 60-70% of cases are asymptomatic. Approximately 80% of patients with acute HCV develop chronic infection; however, some patients clear HCV spontaneously. Cirrhosis develops in up to 20% of patients with chronic hepatitis C over 20-30 years.2 Once cirrhosis is established, complications such as jaundice, ascites, variceal haemorrhage and encephalopathy can develop. These complications mark the transition from compensated to decompensa