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    標題: Less Severe but Prolonged Course of Acute Hepatitis A in Human Immunodeficiency Virus (HIV)-Infected Patients Compared With HIV-Uninfected Patients During an Outbreak: A Multicenter Observational Study
    作者: Lee, Yu-Lin
    Chen, Guan-Jhou
    Chen, Nan-Yu
    Liou, Bo-Huang
    Wang, Ning-Chi
    Lee, Yuan-Ti
    Yang, Chia-Jui
    Huang, Yu-Shan
    Tang, Hung-Jen
    Huang, Shie-Shian
    Lin, Yi-Chun
    Cheng, Chien-Yu
    Lee, Chen-Hsiang
    Chen, Tun-Chieh
    Wu, Ting-Shu
    Litt, Chun-Eng
    Lu, Po-Liang
    Hung, Chien-Ching
    貢獻者: Changhua Christian Hosp, Dept Internal Med
    Natl Taiwan Univ Hosp, Dept Internal Med
    Natl Taiwan Univ, Coll Med
    Chang Gung Univ, Coll Med, Chang Gung Mem Hosp, Dept Internal Med
    Hsinchu MacKay Mem Hosp, Dept Internal Med
    Natl Def Med Ctr, Triserv Gen Hosp, Dept Internal Med
    Chung Shan Med Univ, Sch Med
    Chung Shan Med Univ Hosp, Dept Internal Med
    Far Eastern Mem Hosp, Dept Internal Med
    Natl Yang Ming Univ, Sch Med
    Natl Taiwan Univ Hosp, Hsin Chu Branch, Dept Internal Med
    Chi Mei Med Ctr, Dept Internal Med
    Chia Nan Univ Pharm & Sci, Dept Hlth & Nutr
    Keelung Chang Gung Mem Hosp, Dept Internal Med
    Minist Hlth & Welf, Taoyuan Gen Hosp, Dept Internal Med
    Natl Yang Ming Univ, Sch Publ Hlth
    關鍵字: viral hepatitis
    men who have sex with men
    fecal-oral transmission
    sexually transmitted disease
    coagulopathy
    日期: 2018-11-15
    上傳時間: 2019-11-15 15:47:15 (UTC+8)
    出版者: OXFORD UNIV PRESS INC
    摘要: Background. This multicenter retrospective cohort study aimed to compare the clinical presentations and evolution of acute hepatitis A (AHA) between human immunodeficiency virus (HIV)-infected patients and HIV-uninfected counterparts during the AHA outbreak. Methods. Clinical and laboratory data were collected from the medical records of the patients with AHA at the 14 hospitals around Taiwan between May 2015 and May 2017. Results. A total of 297 adult patients with AHA were included during the study period. Their mean age was 31.4 years (range, 19.0-76.1 years); 93.4% were men and 58.6% were men who have sex with men. Of 265 patients with known HIV serostatus, 166 (62.6%) were HIV infected. Compared with HIV-uninfected patients, HIV-infected patients had a lower peak alanine aminotransferase (ALT) level (median, 1312 vs 2014 IU/L, P = .003), less coagulopathy (6.0% vs 16.2%, P = .007), and less hepatomegaly or splenomegaly on imaging studies, but a higher rate of delayed resolution of hepatitis (38.8% vs 21.3%, P = .009). HIV-infected patients with plasma RNA load <1000 copies/ml, while receiving combination antiretroviral therapy (cART) had a higher peak ALT level (median, 1420 vs 978 IU/L P = .006) and less delay in resolution of hepatitis (30.6% vs 48.8%, P = .047) than patients without cART or with plasma RNA load >= 1000 copies/mL. Conclusions. During an AHA outbreak, HIV-infected patients had a lower severity, but delayed resolution, of AHA than HIV-uninfected patients. Better viral suppression by cART alleviated the impact of HIV infection on the disease course of AHA in HIV-infected patients.
    link: http://dx.doi.org/10.1093/cid/ciy328
    關聯: Computers & Education, v.67, n.10, pp.1595-1602
    Appears in Collections:[保健營養系(所) ] 期刊論文

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