Noncirrhotic Portal Hypertension in Perinatally HIV-infected Adolescents Treated With Didanosine-containing Antiretroviral Regimens in Childhood
Autor: | Dasja Pajkrt, Thanyawee Puthakanit, Bart G. P. Koot, Henriette J. Scherpbier, Jintanat Ananworanich, Caroline Foster, Marc van der Valk, Taco W. Kuijpers, Marius van den Bergh Weerman, Eline E. Deurloo, Valeska Terpstra |
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Přispěvatelé: | AII - Amsterdam institute for Infection and Immunity, Paediatric Infectious Diseases / Rheumatology / Immunology, Other departments, Pathology, CCA -Cancer Center Amsterdam, Radiology and Nuclear Medicine, Infectious diseases, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Paediatric Gastroenterology |
Rok vydání: | 2016 |
Předmět: |
Adult
0301 basic medicine Microbiology (medical) Pediatrics medicine.medical_specialty Adolescent MEDLINE HIV Infections Young Adult 03 medical and health sciences 0302 clinical medicine Hiv infected Hypertension Portal Humans Medicine Young adult Didanosine business.industry Infectious disease transmission medicine.disease 030112 virology Infectious Disease Transmission Vertical Infectious Diseases Anti-Retroviral Agents Liver Pediatrics Perinatology and Child Health Portal hypertension Female 030211 gastroenterology & hepatology business Liver pathology medicine.drug |
Zdroj: | Pediatric infectious disease journal, 35(8), e248-e252. Lippincott Williams and Wilkins |
ISSN: | 0891-3668 |
Popis: | Noncirrhotic portal hypertension (NCPH) has been reported in HIV-infected adults. Antiretroviral drugs, as well as genetic and thrombophilic predisposition, have been suggested as possible etiologic factors. Clinical data were collected from 6 HIV-infected patients attending the Infectious Diseases Departments at respectively Emma Children's Hospital Academic Medical Centre in Amsterdam, The Thai Red Cross AIDS Research Centre, Bangkok, Imperial College Healthcare NHS Trust, London who were diagnosed with NCPH. All underwent extensive blood analysis, liver ultrasound, liver elastography, esophagogastroduodenoscopy and percutaneous needle liver biopsy for histological evaluation. We describe 6 perinatally HIV-infected adolescents, all female, who developed NCPH after prolonged exposure during childhood to a didanosine-containing antiretroviral regimen. Histology and electron microscopy showed periportal fibrosis and mitochondrial damage as key findings in their liver biopsies. One of these 6 patients required surgical intervention, the remainder have been managed conservatively to date. Thus, symptomatic NCPH may present in adolescence after perinatally acquired HIV-1 infection. In this case series, risk factors included female sex and prolonged exposure to antiretroviral regimens that included the nucleoside-analogue didanosine in childhood |
Databáze: | OpenAIRE |
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