Document Detail


Noncirrhotic portal hypertension in patients with human immunodeficiency virus-1 infection.
MedLine Citation:
PMID:  18639498     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND & AIMS: Noncirrhotic portal hypertension (NCPH) is unusual in North American patients. This study characterized patients with NCPH and human immunodeficiency virus-1 (HIV-1) infection to identify potential risk factors for this association. METHODS: Eleven consecutive patients from our urban hepatology clinic with HIV-1 infection and NCPH were the subject of this series. Case histories, including medication lists and laboratory data, were analyzed. RESULTS: Age at diagnosis was 51 +/- 7 years. CD4 count was 303 +/- 185 cells/mL, and HIV viral load was <75 copies/mL in 9 patients. Didanosine was the only medication taken by all patients; 10 each had taken lamivudine and zidovudine. In the 10 patients tested, 8 had at least 1 thrombophilic abnormality; 6 were deficient in protein S, and 2 had multiple abnormalities. Nodular regenerative hyperplasia was observed in all 11 and portal venulopathy in 5 patients. All patients had esophageal varices; 3 developed variceal bleeding. Six patients had ascites; 2 required transjugular intrahepatic portal systemic shunt. CONCLUSIONS: Exposure to didanosine and/or a hypercoagulable tendency might predispose patients infected with HIV-1 to vascular changes resulting in NCPH.
Authors:
Sophia Saifee; Dean Joelson; James Braude; Roshan Shrestha; Mark Johnson; Marty Sellers; Michael R Galambos; Raymond A Rubin
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Publication Detail:
Type:  Journal Article     Date:  2008-07-17
Journal Detail:
Title:  Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association     Volume:  6     ISSN:  1542-7714     ISO Abbreviation:  Clin. Gastroenterol. Hepatol.     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-10-20     Completed Date:  2008-12-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101160775     Medline TA:  Clin Gastroenterol Hepatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1167-9     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Atlanta Medical Center, Atlanta, Georgia, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Anti-HIV Agents / therapeutic use
CD4 Lymphocyte Count
Didanosine / therapeutic use
Female
HIV Infections / complications*,  drug therapy,  virology*
HIV-1 / isolation & purification*
Humans
Hypertension, Portal / etiology*
Lamivudine / therapeutic use
Male
Middle Aged
Risk Factors
Thrombophilia
Viral Load
Zidovudine / therapeutic use
Chemical
Reg. No./Substance:
0/Anti-HIV Agents; 134678-17-4/Lamivudine; 30516-87-1/Zidovudine; 69655-05-6/Didanosine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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