2013; 19: 25 32 HIV 1, 2 1 1 1 1 HIV 7 3 HCV, 2 HBV B C 2 HCC 2 F 2 RC 1 2.1 F 1 RC 0 30.4 4 HCV 9 HCC 13.5 3 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: 25 32 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 1 113-8677 3-18-22 2 370-0829 36 1 Division of Hepatology, Tokyo Metropolitan Cancer and Infectious Disease Center, Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113-8677 Japan 2 Division of Gastroenterology, National Hospital Organization, Takasaki General Medical Center, 36 Takamatsu-cho, Takasaki-shi, Gunma, 370-0829 Japan 2012 5 27 2012 10 9 HIV II. 2002 2010 HIV 7 1 52.1 36 71 C 3 B 2 B C HBs HCV 2 hepatocellular carcinoma HCC C 1 B C 1 B C 1 Vp 3 HIV 1 1 5 F 2 6 F 3 1 RC 1 RC 2 30.4 8 111 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
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 F2 2 10 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 F2 1 11 C 25 6 M 52 nbnc EIS EVL 2 F2 2 8 B 111 7 M 62 nbnc EIS EVL 4 F2 2 7 B 16 HCC CPS child-pugh score, CPG child-pugh grade EIS III. HIV 10 2 48 201 T-Bil 1.4 mg dl 0.4 2.8 Alb 2.9 g dl 2.2 3.5 PT 67.3 42 99 Child-Pugh Grade A 0 B 5 C 2 Child-Pugh CP 8.4 7 11 CP C 8.7 7 10 B 9 7 11 B C 7.5 7 8 2 2.1 2 3 F 1 RC 0 4 3.4 2 5 5 3 HCC 1 1 2 2 1 9 3 C 9 8 11 B 35 25 45 B C 63.5 16 111 HCC 13.5 11 16 IV. 1 HIV B C 1. case 3 36 B 1985 HIV 1991 2 T-Bil mg dl Alb g dl PT CP score C 3 1.6 1.0 2.7 0.6 62 3.8 8.7 1.5 B 2 1.0 0.8 2.8 0.6 71 40 9.0 2.8 nbnc 2 1.5 0.1 3.4 0.2 72 0.7 7.5 0.7 7 1.4 0.8 2.9 0.6 67 17 8.4 1.6 HIV 1992 C 2000 genotype 2 C 2004 F 1, RC 0 2008 5 F 2, RC 2 1A, B T-Bil 0.7 mg dl, Alb 2.2 g dl, PT 62 Child-Pugh 9 grade B. 2008 6 1 AS EIS EVL 1 AS EIS B APTT 11 F 1, RC 0 1C, D 12 2009 2 2 HIV B 1. case 5 51 B 1996 1998 HIV HIV HBV-DNA T-Bil 10 ml 26 2013; 19: 25 32
A B C D 1 1 A, B F 2, RC 1 C, D 5 2 F 1, RC 0 2007 2010 2 F 2, RC 1 2A, B T-Bil 1.6 mg dl, Alb 2.3 g dl, PT 42 Child-Pugh 11 grade C. 2010 3 1 AS EIS EVL 1 AS EIS F 1, RC 1 6 8 1 AS EIS 11 2C, D 2 HIV 2010 6 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 1999 4 2001 CT 5A 2002 F 2, RC 1 6A, B 2003 1 T-Bil 1.4 mg dl, Alb 3.5 g dl, PT 2013; 19: 25 32 27
A B C D 2 2 A, B F 2, RC 1 C, D 8 4 3 2 HAART HBV-DNA TDF FTC RAL 28 2013; 19: 25 32
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. 2003 1 5 EO EIS EVL 1 AS EIS 9 6C, D 2003 2008 CT 5B HAART 2009 6 d4t 3TC FPV r V. HIV HBV HCV HIV HCV 20 2 HBV 6.4 3 1996 HAART 2013; 19: 25 32 29
A B C D 6 3 A, B F 2, RC 1 C, D 1 2 HIV 29.4 100 8.8 100 4 HIV HIV HAART HIV AIDS 1, 5 HIV NASH HIV HIV HIV or AIDS HIV HIV 7 3 42.9 HCV 3 9 HCV 49.3 HIV C HCV HIV CD4 200 ml 7 HAART HIV HCV 8 HIV HIV HCV 9 HCV 30 2013; 19: 25 32
HIV 3 2 1 1 HIV HCV 7 2 28.6 HBV 2 1 25 1 45 HCV HIV B HBV HIV HBV HBV HAART 10 HIV B 2 HIV HIV B 1 HBV HIV HAART HBV 2 28.6 B C 1 HIV ALT 100 IU l NASH HCC 16 1 3 HIV 4 HIV ddi 3 7 d4t 3TC NFV HAART HARRT 4 5 9 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 1 2013; 19: 25 32 31
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: 492 497 2 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: 657 663 3 Koike K, Kikuchi Y, Kato M, et al: Prevalence of hepatitis B virus infection in Japanese patients with HIV. Hepatol Res. 2008; 38: 310 314 4 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: 853 860 5 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: 1632 1641 6 Catalina MV, Barrio J, Garcia A, et al: Characteristics of bleeding from esophageal-gastric varices in patients with HIV infection. Gastroenterol Hepatol 2002; 25: 443 447 7 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: 1054 1058 8 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: 1708 1713 9 Wilde JT: HIV and HCV coinfection in haemophilia. Haemophilia 2004; 10: 1 8 10 HIV HIV 2011 15 11 Schneiderman DJ, Arenson DM, Cello JP, et al: Hepatic disease in patients with the acquired immune deficiency syndrome (AIDS). Hepatology 1987; 7: 925 930 12 Bongiovanni M, Tordato F: Steatohepatitis in HIV-infected subjects: pathogenesis, clinical impact and implications in clinical management. Curr HIV Res. 2007; 5: 490 498 13 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: 626 635 14 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: 346 355 15 Mendizabal M, Craviotto S, Chen T, et al: Noncirrhotic portal hypertension: another cause of liver disease in HIV patients. Ann Hepatol. 2009; 8: 390 395 16 Brinie GG, Quigley EM, Clements GB, et al: Endoscopic transmission of hepatitis B virus. Gut 1983; 24: 171 174 17 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: 237 240 18 2012 1 32 2013; 19: 25 32