HIV/AIDS患者伴发肝损伤的肝脏病理学分析

doi:10.19871/j.cnki.xfcrbzz.2021.04.004

新发传染病电子杂志 ›› 2021, Vol. 6 ›› Issue (4): 285-288.doi: 10.19871/j.cnki.xfcrbzz.2021.04.004

HIV/AIDS患者伴发肝损伤的肝脏病理学分析

黄志忠¹, 吕建楠², 覃江龙², 李品超³, 牟敏红⁴, 覃亚勤¹

1.南宁市第四人民医院肝病科,南宁530023;
2.南宁市第四人民医院感染科,南宁 530023;
3.南宁市第八人民医院外科,南宁 530001;
4.南宁市第四人民医院病理科,南宁530023

收稿日期:2020-12-31 出版日期:2021-11-30 发布日期:2021-12-13
通讯作者: 覃亚勤,Email：2858649716@qq.com
基金资助:
广西壮族自治区卫生健康委会自筹课题（Z20211129）; 南宁市科技局重大专项（20193008）

Liver pathological analysis in human immunodeficiency virus or acquired immune deficiency syndrome patients with liver damage

Huang Zhizhong¹, Lyu Jiannan², Qin Jianglong², Li Pinchao³, Mou Minhong⁴, Qin Yaqin¹

1. Department of Hematology, The Fourth People's Hospital of Nanning, Nanning 530023, China;
2. Department of Infectious Disease, The Fourth People's Hospital of Nanning, Nanning 530023, China;
3. Department of Surgery, The Eighth People's Hospital of Nanning, Nanning 530001, China;
4. Department of Pathology, The Fourth People's Hospital of Nanning, Nanning 530023, China

Received:2020-12-31 Online:2021-11-30 Published:2021-12-13

摘要/Abstract

摘要： 目的探讨伴发肝损伤的HIV/AIDS患者肝脏病理学类型及其特点,为AIDS患者的肝脏疾病的诊断和治疗提供依据。方法超声引导下经皮穿刺取HIV/AIDS患者肝脏组织进行病理检查,通过苏木精-伊红、过碘酸雪夫和淀粉酶消化过碘酸雪夫染色,光学显微镜观察形态学并描述组织病理特点,结合临床病例资料对病理结果进行统计分析。结果 64例HIV/AIDS患者的肝脏病理检查表现为病毒性肝炎22例（34.4%）,肝脏肿瘤23例（35.9%）,药物性肝炎5例（7.8%）,机会性感染7例（10.9%）,非特异性病变7例（10.9%）。其中乙型病毒性肝炎例12例,丙型病毒性肝炎10例,肝细胞癌11例,弥漫大B细胞淋巴瘤8例,炎性肌纤维母细胞瘤3例,结核分枝杆菌感染2例,马尔尼菲篮状菌感染2例。结论 HIV/AIDS患者肝损伤的病因中病毒性肝炎主要为乙型病毒性肝炎和丙型病毒性肝炎,肝脏肿瘤主要为肝细胞癌和弥漫大B细胞淋巴瘤,临床上需加强对HIV/AIDS患者伴发各种肝脏疾病的诊断和治疗。

关键词: 艾滋病, 肝损伤, 病毒性肝炎, 弥漫大B细胞淋巴瘤, 病理学

Abstract: Objective To investigate the pathological types and features of in HIV/AIDS patients with liver damage, and we try to provide evidence for the diagnosis and treatment of liver diseases in acquired immunodeficiency syndrome. Methods The tissues of liver were obtained from HIV/AIDS patients with liver damage for pathological examination by percutaneous puncture under ultrasonographic guidance. The pathological results were observed by light microscope after Hematoxylin-Eosin, acid-fast, periodic acid-Schiff, and digested-PAS staining. The pathological characteristics and histopathological features of the hepatic tissue were described and analyzed. Results Among the 64 HIV/AIDS patients with liver damage, the viral hepatitis were found in 22 patients (34.4%), the hepatic tumors were found in 23 patients(35.9%), the drug hepatitis were found in 5 patients(7.8%), the opportunistic infectious diseases were found in 7 patients(10.9%) and the nonspecific lesions were found in 7 patients(10.9%).The pathological findings of hepatitis B virus, hepatitis C virus, hepatocellular carcinoma, diffuse large B cell lymphoma, inflammatory myofibroblastoma, mycobacterium tuberculosis infection and talaromyces marneffei infection were 12,10,11,8,3,2 and 2 cases, respectively. Conclusion The main cause of liver damage in HIV/AIDS patients are viral hepatitis, such as hepatitis B virus and hepatitis C virus,the liver tumors are hepatocellular carcinoma and mainly diffuse large B cell lymphoma.Therefore, we need to strengthen the diagnosis and treatment of HIV/AIDS patients with various liver diseases.

Key words: Acquired immunodeficiency syndrome, Hepatic damage, Hepatitis virus, Diffuse large B cell lymphoma, Pathology

黄志忠, 吕建楠, 覃江龙, 李品超, 牟敏红, 覃亚勤. HIV/AIDS患者伴发肝损伤的肝脏病理学分析[J]. 新发传染病电子杂志, 2021, 6(4): 285-288.

Huang Zhizhong, Lyu Jiannan, Qin Jianglong, Li Pinchao, Mou Minhong, Qin Yaqin. Liver pathological analysis in human immunodeficiency virus or acquired immune deficiency syndrome patients with liver damage[J]. Electronic Journal of Emerging Infectious Diseases, 2021, 6(4): 285-288.

参考文献

[1] WHO.Fact sheet: latest statistics on the status of the AIDS epidemic[EB/OL].[2018-07-23]. http://www.unaids.org/en/resources/fact-sheet.
[2] HELEN K, BRUNO L, MANUEL B, et al.Incidence and risk factors for chronic elevation of alanine aminotransferase levels in hiv-infected persons without hepatitis b or c virus co-infection[J]. Clin Infect Dis, 2010,50(4):502-511.
[3] SORIANO V, PUOTI M, GARCIA-GASCÓ P, et al.Antiretroviral drugs and liver injury[J]. Aids, 2008,22(1):1-13.
[4] HUANG YS, SUNH Y, CHANG SY, et al.Long-term virological and serologic responses of chronic hepatitis B virus infection to tenofovir disoproxil fumarate-containing regimens in patients with HIV and hepatitis B coinfection[J]. Hepatol Int, 2019, 13(4): 431-439.
[5] HONEYCUTT JB, THAYER WO, BAKER CE, et al.Hiv persistence in tissue macrophages of humanized myeloid-only mice during antiretroviral therapy[J]. Nat Med, 2017, 23(5): 638-643.
[6] POLES MA, DIETERICH DT, SCHWARZ ED, et al.Liver biopsy findings in 501 patients infected with human immunodeficiency virus (HIV)[J]. J Acquir Immune Defic Syndr Hum Retrovirol, 1996, 11(2):170-177.
[7] SHIELS MS, ENGELS EA.Evolving epidemiology of hiv-associated malignancies[J]. Curr Opin HIV AIDS, 2017,12(1):6-11.
[8] 卢亦波, 施裕新, 刘晋新, 等. 艾滋病合并卡波西肉瘤多脏器组织侵犯的影像学分析[J/CD].新发传染病电子杂志, 2020, 5(1):8-15.
[9] RADU O, PANTANOWITZ L.Kaposi sarcoma[J]. Arch Pathol Lab Med, 2013,137(2):289-294.
[10] BASHIR MR, SOHAIBANI MOA, AL-RIKABI AC.An unusual case of inflammatory myofibroblastic tumor of the appendix masquerading as acute appendicitis[J]. Oman Med J, 2018,33(3):250-252.
[11] CAMBREA SC, RESUL G, BULBUC I, et al.Pulmonary inflammatory myofibroblastic tumor in an aids patient[J]. Rom J Morphol Embryol, 2014, 55(2):407-412.
[12] DRAGOVIC G, NIKOLIC K, DIMITRIJEVIC B, et al.Severe hepatotoxicity induced by efavirenz in a treatment-naïve, low body mass index hiv-infected, female patient with no hepatitis and other virus co-infections[J]. Ultrastruct Pathol, 2019,43(4-5):1-4.
[13] KARIN N, A. MJ, JOSEFA RM, et al. Liver toxicity associated with antiretroviral therapy including efavirenz or ritonavir-boosted protease inhibitors in a cohort of hiv/hepatitis c virus co-infected patients[J]. J Antimicrob Chemother,2011,66(11):2605-2614.
[14] MANOSUTHI W, SUKASEM C, LUEANGNIYOMKUL A, et al.Cyp2b6 haplotype and biological factors responsible for hepatotoxicity in hiv-infected patients receiving efavirenz-based antiretroviral therapy[J]. Int J Antimicrob Agents, 2014,42(3):292-296.
[15] 覃江龙, 梁纲, 卢祥婵, 等. 艾滋病合并肺结核和(或)马尔尼菲蓝状菌病的影像学研究[J/CD]. 新发传染病电子杂志, 2018,3(3):171-174.
[16] 覃江龙, 秦英梅, 卢亦波, 等. 广西艾滋病马尔尼菲蓝状菌机会性感染的流行病学调查[J]. 中国热带医学,2019,19(9):896-899.
[17] YOUSUKH A, JUTAVIJITTUM P, PISETPONGSA P, et al.Clinicopathologic study of hepatic penicillium marneffei in northern thailand[J]. Arch Pathol Lab Med, 2004,128(2):191-194.

HIV/AIDS患者伴发肝损伤的肝脏病理学分析

Liver pathological analysis in human immunodeficiency virus or acquired immune deficiency syndrome patients with liver damage

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价

[1]	詹香明, 卢洪洲. 新型冠状病毒肺炎对全球HIV感染者影响的研究进展[J]. 新发传染病电子杂志, 2021, 6(4): 356-360.
[2]	陈瑶, 韩亚坤, 吴强, 何仁亮. HIV相关感觉神经病的研究进展[J]. 新发传染病电子杂志, 2021, 6(4): 361-367.
[3]	谢璐蔓, 黄葵, 覃善芳. 381例艾滋病患者肠道感染情况及耐药性分析[J]. 新发传染病电子杂志, 2021, 6(3): 220-224.
[4]	任荣, 程晰, 刘荣荣, 袁功玲, 刘静, 姚文妍, 李敏. 艾滋病合并粟粒性肺结核的CT影像与CD4⁺T淋巴细胞低下程度的相关分析[J]. 新发传染病电子杂志, 2021, 6(3): 242-246.
[5]	郑祎, 王辉. 艾滋病合并马尔尼菲篮状菌感染的诊治临床研究进展[J]. 新发传染病电子杂志, 2021, 6(2): 151-154.
[6]	黎瑜, 刘夏, 周静如, 邹俊, 卢亦波. 艾滋病合并耐多药肺结核胸部CT表现分析[J]. 新发传染病电子杂志, 2021, 6(1): 27-30.
[7]	刘特, 杨根东, 刘文浩, 郑广平, 曾旋, 黎翠竹, 彭宇, 张辉, 王展. CT仿真内镜对艾滋病合并支气管结核的临床应用价值[J]. 新发传染病电子杂志, 2021, 6(1): 40-44.
[8]	汪徐, 何玉麟. 肝脏血管周围晕征的影像表现及其临床意义[J]. 新发传染病电子杂志, 2021, 6(1): 62-64.
[9]	葛宪民, 朱金辉, 蒋武, 蓝光华, 唐驰, 李江恒, 林倩, 陈欢欢, 罗柳红, 李珊珊, 李彬, 温平镜, 黄玉满, 孟琴, 刘帅凤, 吴秀玲, 黄精华, 陆华湘, 邓月琴. 南宁市HIV阳性孕产妇接受母婴阻断治疗后18月龄幼儿体格发育不良10年回顾性研究[J]. 新发传染病电子杂志, 2020, 5(4): 243-248.
[10]	朱娅男, 刘德纯. 鼻腔鼻窦曲霉菌病103例病理学观察[J]. 新发传染病电子杂志, 2020, 5(4): 249-252.
[11]	农云洁, 农恒荣, 黄裕兰, 黄小桂, 卢日贞. 艾滋病合并肺部感染超声影像学研究进展[J]. 新发传染病电子杂志, 2020, 5(4): 277-279.
[12]	欧健, 李伟新, 马钰婷, 汤红丽, 伍秋云, 文乐敏. 清热解毒方药对艾滋病抗病毒治疗后脂肪代谢障碍综合征的临床研究[J]. 新发传染病电子杂志, 2020, 5(3): 169-172.
[13]	唐欷柯, 彭智鹏, 梁联哨, 郑艳青, 谢周华. 艾滋病合并神经梅毒感染的最新研究进展[J]. 新发传染病电子杂志, 2020, 5(3): 203-206.
[14]	胡志亮, 许传军. 人类免疫缺陷病毒相关隐球菌免疫重建炎症综合征研究进展[J]. 新发传染病电子杂志, 2020, 5(2): 126-130.
[15]	卢亦波, 施裕新, 刘晋新, 张倩倩, 谢汝明, 鲁植艳, 杨豫新, 张娜, 郑广平, 叶雯, 陈步东, 吴锋耀, 李宏军, 陆普选. 艾滋病合并卡波西肉瘤多脏器组织侵犯的影像学分析[J]. 新发传染病电子杂志, 2020, 5(1): 8-15.