肝移植治疗HIV合并HCV阳性患者的研究进展  

Research progress on the application of liver transplantation in HIV combined with HCV positive patients

作　　者：颜曦婧 杨扬[1] Yan Xijing;Yang Yang(Department of Hepatic Surgery,Liver Transplantation Center,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China)

机构地区：[1]中山大学附属第三医院肝脏外科暨肝移植中心,广州510630

出　　处：《器官移植》2020年第6期677-684,共8页Organ Transplantation

基　　金：国家“十三五”重大科技专项(2017ZX10203205-006-001);国家自然科学基金(81770648);广东省自然科学基金(2015A030312013);广东省科技项目(2014B030301041、2017B020209004);广州市科技项目(201400000001-3)。

摘　　要：随着高效抗逆转录病毒治疗(HAART)时代的到来,获得性免疫缺陷综合征(AIDS)已经从不可治愈的绝症逐渐演变为可控型慢性疾病。由于AIDS患者生命周期的延长,慢性肾衰竭和(或)慢性肝衰竭已经成为其主要的死亡原因,而慢性肝衰竭的AIDS患者往往伴有丙型肝炎病毒(HCV)感染。人类免疫缺陷病毒(HIV)感染曾被认为是肝移植的禁忌证,随着医学界认知的不断深入和手术管理经验的提高,HIV阳性肝移植受者的数量日渐上升,并且取得了较好的远期生存率。但是HIV合并HCV阳性受者肝移植术后3、5、10年生存率仍然很低。为此,本文主要总结了近年来HIV阳性患者肝移植手术的开展情况、HIV合并HCV阳性患者的疾病进程及术后丙型病毒性肝炎复发的治疗措施。With the advent of highly active antiretroviral therapy(HAART),acquired immune deficiency syndrome(AIDS)has gradually evolved from an incurable terminal disease to a controllable chronic disease.Due to the extended survival of AIDS patients,chronic renal failure and(or)chronic liver failure have become the main cause of death,and AIDS patients with chronic liver failure are constantly complicated with hepatitis C virus(HCV)infection.Human immunodeficiency virus(HIV)infection was previously considered as a contraindication for liver transplantation.With the deepening of medical cognition and improvement of surgical management experience,the quantity of HIV positive liver transplantation recipients has been steadily elevated and high long-term survival rate has been achieved.Nevertheless,the 3-,5-,and 10-year survival rates after liver transplantation of HIV combined with HCV positive patients remain extremely low.In this article,the development of liver transplantation in HIV positive patients,the disease progression of HIV combined with HCV positive patients,and the treatment for the recurrence of viral hepatitis C after the operation were summarized.

关 键 词：肝移植 丙型肝炎病毒(HCV) 人类免疫缺陷病毒(HIV) 获得性免疫缺陷综合征(AIDS) 高效抗逆转录病毒治疗 终末期肝病 丙型病毒性肝炎复发 直接抗病毒药物 

分 类 号：R617[医药卫生—外科学] R512.91[医药卫生—临床医学]