儿科艾滋病病毒合并肝炎感染:治疗和预防的进展。

Chiara Rubino, Mariangela Stinco, Giuseppe Indolfi
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引用次数: 0

摘要

综述目的:分析艾滋病病毒感染儿童肝炎合并感染管理的主要证据和建议:摘要:由于存在共同的传播途径,尤其是在三种病毒高度流行的地区,艾滋病病毒感染者(PLHIV)合并感染病毒性肝炎是一个全球性问题。病毒性肝炎合并感染会加速肝病恶化,增加发病率和死亡率,即使是接受抗逆转录病毒疗法(ART)抑制治疗的患者也不例外。应常规筛查 PLHIV 中的病毒性肝炎,一旦确诊为病毒性肝炎,应密切监测 PLHIV 的肝病进展和并发症。感染 HIV-HBV 病毒的儿童应接受抗逆转录病毒疗法(ART)治疗,该疗法含有对这两种病毒都有效的药物。HIV-HCV合并感染儿童应接受直接作用抗病毒药物(DAA)治疗,以根除HCV感染。应采取并鼓励减少 HBV 和 HCV 垂直和水平传播的预防措施(抗 HBV 疫苗接种和免疫球蛋白、妊娠期抗 HBV 治疗、育龄人群抗 HCV DAAs、避免血液接触、性屏障预防措施),尤其是在高流行率国家。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Hepatitis co-infection in paediatric HIV: progressing treatment and prevention.

Purpose of review: To analyse the main evidence and recommendations for the management of hepatitis co-infection in children living with HIV.

Recent findings: We analysed available data pertaining to the natural history of liver disease and treatment of co-infected children.

Summary: Viral hepatitis co-infection in people living with HIV (PLHIV) is a global problem owing to the shared routes of transmission, particularly in areas of high endemicity for the three viruses. Viral hepatitis co-infection can accelerate liver disease progression and increase morbidity and mortality, even in patients on suppressive antiretroviral treatment (ART). Viral hepatitis should be routinely screened in PLHIV and, once diagnosed with viral hepatitis, PLHIV should be closely monitored for liver disease progression and complications. Children living with HIV-HBV co-infection should be treated with ART containing agents which are active against both viruses. Children living with HIV-HCV co-infection should receive directly acting antivirals (DAA) to eradicate HCV infection. Prevention measures to reduce vertical and horizontal transmission of HBV and HCV (anti-HBV vaccination and immunoglobulins, anti-HBV treatment in pregnancy, anti-HCV DAAs in people of childbearing age, avoiding blood contact, sexual barrier precautions) should be adopted and encouraged, particularly in high endemicity countries.

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