HIV/AIDS病人HAART致肝功能损害66例分析

目的探讨高效抗反转录病毒治疗（HAART）对艾滋病病毒（HIV）感染者/艾滋病（AIDS）病人（简称HIV/AIDS病人）肝功能的影响。方法回顾性分析HIV/AIDS病人抗病毒治疗24个月内肝功能的变化情况。结果共计调查755例HIV/AIDS病人,肝功能损害发生率为8.7%（66/755）,以单项转氨酶或胆红素升高为主,轻、中度肝损害占84.8%（56/66）,发生异常的时间为30-485天,中位数75天。其中含奈韦拉平（NVP）方案治疗者肝功能损害的发生率为7.1%（33/467）、含依非韦伦（EFV）方案发生率为11.5%（33/288）。肝损害级别：1级34例,2级22例,3级10例。结论 HIV/AIDS病人在抗病毒治疗过程中轻中度肝损害常见,应严密观察,及时处理,以保证HAART的顺利进行。

An analysis of 66 HIV/AIDS cases with liver damage caused by antiretroviral drugs

Objective To explore the impact of highly active antiretroviral therapy （HAART） on liver function in patients with human immunodeficiency virus （HIV）/acquired immune deficiency syndrome （AIDS）. Methods We retrospectively analyzed the changes of liver function in 755 HIV/AIDS patients with HAART in two years. Results A total of 755 HIV/AIDS patients were investigated. The incidence of liver damage was 8.7% （66/755）, mainly presented with elevated level of transaminase or hilirubin. Among the 66 cases, mild to moderate liver damage accounted for 84.8% （56/66）, and the median time of liver damage occurrence was 75 days （range： 30-485 days）. The incidence of liver damage was 7.1% （33/467） among patients on nevirapine-hased regimens and 11.5% （33/288） among patients on efavirenz-hased regimens. Grade Ⅰ, Ⅱ and Ⅲ liver damage developed in 34, 22 and 10 cases, respectively. Conclusion Mild-to-moderate liver damage is common in HIV/AIDS patients with HAART, which should be closely observed and timely treated to ensure the smooth progress of HAART.