HIV. KEY WORDS: HIV, esophageal varices, endoscopic injection sclerotherapy (EIS), endoscopic variceal ligation (EVL)

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1 2013; 19: HIV 1, HIV 7 3 HCV, 2 HBV B C 2 HCC 2 F 2 RC F 1 RC HCV 9 HCC HCC 1 1 AIDS B C HIV HIV HCV HIV KEY WORDS: HIV, esophageal varices, endoscopic injection sclerotherapy (EIS), endoscopic variceal ligation (EVL) Hoshino T 1, 2, Hayashi S 1, Imamura J 1, Kimura K 1, Saeki S 1 : Endoscopic therapy for esophageal varices with HIV infection. JJPH 2013; 19: I. acquired immune deficiency syndrome AIDS human immunodeficiency virus HIV CD4 HIV HIV highly active antiretroviral therapy HAART 1 B C HBV HCV HIV nonalcoholic steatohepatitis NASH HIV Division of Hepatology, Tokyo Metropolitan Cancer and Infectious Disease Center, Komagome Hospital, Honkomagome, Bunkyo-ku, Tokyo, Japan 2 Division of Gastroenterology, National Hospital Organization, Takasaki General Medical Center, 36 Takamatsu-cho, Takasaki-shi, Gunma, Japan HIV II HIV C 3 B 2 B C HBs HCV 2 hepatocellular carcinoma HCC C 1 B C 1 B C 1 Vp 3 HIV F 2 6 F 3 1 RC 1 RC endoscopic variceal ligation EVL 5 ethanolamine oleate EO 1 Aethoxysklerol AS endoscopic injection sclerotherapy with ligation EIS EVL EIS EVL F 1 RC 0 RC 25

2 1 HIV case age F RC CPS CPG HCC Vp 1 M 48 C EVL 5 F3 1 7 B 8 2 M 71 C EIS EVL 2 F C 11 3 M 36 C EIS EVL 2 F2 2 9 B 8 4 M 45 B EIS EVL 5 F2 2 7 B 45 5 M 51 B EIS EVL 4 F C 25 6 M 52 nbnc EIS EVL 2 F2 2 8 B M 62 nbnc EIS EVL 4 F2 2 7 B 16 HCC CPS child-pugh score, CPG child-pugh grade EIS III. HIV T-Bil 1.4 mg dl Alb 2.9 g dl PT Child-Pugh Grade A 0 B 5 C 2 Child-Pugh CP CP C B B C F 1 RC HCC C B B C HCC IV. 1 HIV B C 1. case 3 36 B 1985 HIV T-Bil mg dl Alb g dl PT CP score C B nbnc HIV 1992 C 2000 genotype 2 C 2004 F 1, RC F 2, RC 2 1A, B T-Bil 0.7 mg dl, Alb 2.2 g dl, PT 62 Child-Pugh 9 grade B AS EIS EVL 1 AS EIS B APTT 11 F 1, RC 0 1C, D HIV B 1. case 5 51 B HIV HIV HBV-DNA T-Bil 10 ml ; 19: 25 32

3 A B C D 1 1 A, B F 2, RC 1 C, D 5 2 F 1, RC F 2, RC 1 2A, B T-Bil 1.6 mg dl, Alb 2.3 g dl, PT 42 Child-Pugh 11 grade C AS EIS EVL 1 AS EIS F 1, RC AS EIS 11 2C, D 2 HIV HAART HBV-DNA 3 3 HIV B C 1. case 6 52 HBs HCV MRCP 1989 HIV 1991 AZT 1995 ddi 1998 d4t 3TC NFV HAART HIV AZT ALT g-gtp ddi ALT g-gtp HAART CT 5A 2002 F 2, RC 1 6A, B T-Bil 1.4 mg dl, Alb 3.5 g dl, PT 2013; 19:

4 A B C D 2 2 A, B F 2, RC 1 C, D HAART HBV-DNA TDF FTC RAL ; 19: 25 32

5 4 3 ddi ALT g-gtp ddi ddi 4 5 EIS A B 5 3 CT A 2001 CT B 2008 CT 72 Child-Pugh 8 grade B EO EIS EVL 1 AS EIS 9 6C, D CT 5B HAART d4t 3TC FPV r V. HIV HBV HCV HIV HCV 20 2 HBV HAART 2013; 19:

6 A B C D 6 3 A, B F 2, RC 1 C, D 1 2 HIV HIV HIV HAART HIV AIDS 1, 5 HIV NASH HIV HIV HIV or AIDS HIV HIV HCV 3 9 HCV 49.3 HIV C HCV HIV CD4 200 ml 7 HAART HIV HCV 8 HIV HIV HCV 9 HCV ; 19: 25 32

7 HIV HIV HCV HBV HCV HIV B HBV HIV HBV HBV HAART 10 HIV B 2 HIV HIV B 1 HBV HIV HAART HBV B C 1 HIV ALT 100 IU l NASH HCC HIV 4 HIV ddi 3 7 d4t 3TC NFV HAART HARRT ddi ddi HARRT ddi ddi d4t non-alcoholic fatty liver disease NAFLD NASH 12 ddi B C AIDS non-cirrhotic portal hypertension NCPH Kavari 13 NCPH ddi NCPH Cachay 14 ddi NCPH 8 ddi 37 NCPH 4 NCPH 2 ddi NCPH ddi NCPH periportal fibrosis 13 nodular regenerative hyperplasia, hepatoportal sclerosis 15 NASH NASH ddi NCPH Cachay ddi NCPH ddi NCPH 10 1 ddi 10 CT NCPH ddi NCPH ; 19:

8 HBV 16 HCV 17 HIV HIV, HBV, HCV 18 HIV VI. HIV 7 HCV HCC HIV 1 Bica I, McGovern B, Dhar R, et al: Increasing mortality due to end-stage liver disease in patients with human immunodeficiency virus infection. Clin Infect Dis 2001; 32: Yotsuyanagi H, Kikuchi Y, Tsukada K: Chronic hepatitis C in patients co-infected with human immunodeficiency virus in Japan: a retrospective multicenter analysis. Hepatol Res. 2009; 39: Koike K, Kikuchi Y, Kato M, et al: Prevalence of hepatitis B virus infection in Japanese patients with HIV. Hepatol Res. 2008; 38: Palella FJ Jr, Delaney KM, Moorman AC, et al: Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. HIV Outpatient Study Investigators. N Eng J Med 1998; 338: Weber R, Sabin CA, Friis-Møller N, et al: Liver-related deaths in persons infected with the human immunodeficiency virus: the D: A: D study. Arch Intern Med 2006; 166: Catalina MV, Barrio J, Garcia A, et al: Characteristics of bleeding from esophageal-gastric varices in patients with HIV infection. Gastroenterol Hepatol 2002; 25: Benhamou Y, Bochet M, Di Martino V, et al: Liver fibrosis progression in human immunodeficiency virus and hepatitis C virus coinfected patients. The Multivirc Group. Hepatology 1999; 30: Qurishi N, Kreuzberg C, Luchters G, et al: Effect of antiretroviral therapy on liver-related mortality in patients with HIV and hepatitis C virus coinfection. Lancet 2003; 362: Wilde JT: HIV and HCV coinfection in haemophilia. Haemophilia 2004; 10: HIV HIV Schneiderman DJ, Arenson DM, Cello JP, et al: Hepatic disease in patients with the acquired immune deficiency syndrome (AIDS). Hepatology 1987; 7: Bongiovanni M, Tordato F: Steatohepatitis in HIV-infected subjects: pathogenesis, clinical impact and implications in clinical management. Curr HIV Res. 2007; 5: Kovari H, Ledergerber B, Peter U, et al: Association of noncirrhotic portal hypertension in HIV-infected persons and antiretroviral therapy with didanosine: a nested casecontrol study. Clin Infect Dis. 2009; 49: Cachay ER, Peterson MR, Goicoechea M, et al: Didanosine Exposure and Noncirrhotic Portal Hypertension in a HIV Clinic in North America: a Follow-up Study. 2011; 1: Mendizabal M, Craviotto S, Chen T, et al: Noncirrhotic portal hypertension: another cause of liver disease in HIV patients. Ann Hepatol. 2009; 8: Brinie GG, Quigley EM, Clements GB, et al: Endoscopic transmission of hepatitis B virus. Gut 1983; 24: Bronowicki J-P, Venard V, Botte C, et al: Patient-to-patient transmission of hepatitis C virus during colonoscopy. N Engl J Med. 1997; 337: ; 19: 25 32