Unit:
Τομέας ΚλινικοεργαστηριακόςLibrary of the School of Health Sciences
Author:
Androutsakos Theodoros
Dissertation committee:
Γρηγόριος Χατζής, Ομότιμος Καθηγητής, Ιατρική, ΕΚΠΑ
Αθανάσιος Τζιούφας, Καθηγητής, Ιατρική, ΕΚΠΑ
Νικόλαος Σύψας, Καθηγητής, Ιατρική, ΕΚΠΑ
Παναγιώτης Βλαχογιαννόπουλος, Καθηγητής, Ιατρική, ΕΚΠΑ
Παναγιώτης Βουλγαρέλης, Καθηγητής, Ιατρική, ΕΚΠΑ
Σταύρος Σουγιουλτζής, Αναπληρωτής Καθηγητής, Ιατρική, ΕΚΠΑ
Ευσταθία Καψογεώργου, Αναπληρώτρια Καθηγήτρια, Ιατρική, ΕΚΠΑ
Original Title:
HIV και ήπαρ
Translated title:
HIV and the liver
Summary:
The introduction of antiretroviral treatment (ART) for HIV-infected patients has led to a change of these patients' life expectancy, making HIV infection a chronic rather than a fatal disease. This prolongation of patients' survival has resulted in a change of the diseases most commonly seen during HIV infection's natural course, with cardiovascular and liver disease presenting more often than opportunistic infections. As far as liver is concerned, diseases like chronic HBV and HCV infections lead to liver cirrhosis faster in patients with HIV infection, while the prevalence of alcoholic and non-alcoholic disease is steadily rising in these patients. The best method for assesing liver fibrosis is liver biopsy; however it is an invasive procedure that requires hospitalization and is prone to complications. For that reason, non invasive methods for assesing liver fibrosis have been developed; among them transient elastography, measuring liver stifness, seems to provide the most reliable results with high creditability. Transient elastography, however, has also limitations, like high cost, low availability, especially in low income countries, and dependence on operator experience. For that reason various scores have been developed that take into account commonly used laboratory results for determining liver fibrosis. The use of these, so called non-invasive biomarkers of liver disease, in specific groups of patients like those suffering for hepatitis C virus are trustworthy and can replace transient elastography in everyday practice. Even though the application of these non-invasive biomarkers in the general population and patients with HIV/HCV infection is widespread, few studies exist in patients with HIV infection. The aim of the present study was to search for possible risk factors for significant liver fibrosis in a cohort of HIV-infected patients, as well as which non-invasive biomarkers can better determine liver fibrosis in HIV-monoinfected patients. Furthermore we tried to evaluate the efficacy of the new, all oral, treatment against HCV infection in patients with HIV/HCV coinfection. Our study included patients followed by the outpatient liver and the outpatient infectious diseases clinics of the Pathophysiology Department of 'Laiko' General Hospital. As gold standard method for determining liver fibrosis, transient elastography was used.
Main subject category:
Health Sciences
Keywords:
HIV infection, Liver fibrosis, Liver, Non-invasive biomarkers of liver fibrosis
Number of references:
558
