Journal Article

Increasing Mortality Due to End-Stage Liver Disease in Patients with Human Immunodeficiency Virus Infection

Ioana Bica, Barbara McGovern, Rakesh Dhar, David Stone, Katherine McGowan, Rochelle Scheib and David R. Snydman

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 32, issue 3, pages 492-497
Published in print February 2001 | ISSN: 1058-4838
Published online February 2001 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/318501
Increasing Mortality Due to End-Stage Liver Disease in Patients with Human Immunodeficiency Virus Infection

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Highly active antiretroviral therapy has decreased human immunodeficiency virus (HIV)-associated mortality; other comorbidities, such as chronic liver disease, are assuming greater importance. We retrospectively examined the causes of death of HIV-seropositive patients at our institution in 1991, 1996, and 1998–1999. In 1998–1999, 11 (50%) of 22 deaths were due to end-stage liver disease, compared with 3 (11.5%) of 26 in 1991 and 5 (13.9%) of 36 in 1996 (P = .003). In 1998–1999, 55% of patients had nondetectable plasma HIV RNA levels and/or CD4 cell counts of>200 cells/mm3 within the year before death. Most of the patients that were tested had detectable antibodies to hepatitis C virus (75% of patients who died in 1991, 57.7% who died in 1996, and 93.8% who died in 1998–1999; P = NS). In 1998–1999, 7 patients (31.8%) discontinued antiretroviral therapy because of hepatotoxicity, compared with 0 in 1991 and 2 (5.6%) in 1996. End-stage liver disease is now the leading cause of death in our hospitalized HIV-seropositive population.

Journal Article.  3329 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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