Viral hepatitis and liver transplantatation
Notice bibliographique
Résumé
The etiologies and outcomes of acute liver failure (ALF) in HIV + pts are largely unknown.In addition, the long term outcomes of HIV + pts with ALF undergoing transplantation have not been described.The aim of this study is to describe the presenting features, risk factors, and outcomes of adult HIV + pts with ALF enrolled in the ALFSG.METHODS: Clinical outcomes at 3 weeks of consecutive adult ALF HIV + pts enrolled between 1998 and January 2013 were reviewed and a subgroup returned for a study visit at 1 or 2 years after enrollment.RESULTS: Thirty three of the 2264 ALF pts (1.3%) were HIV +, enrolled at 16 sites.Etiologies of ALF included DILI in 11 (33%), acetaminophen (APAP) overdose in 9 (27%), and the remaining 13 (39%) were due to HBV (4), AIH (4), indeterminate (3), HAV (1), and ischemia (1).The age, gender, and racial distribution of our cohort was similar to that of HIV+ pts in the general US population (2010 CDC HIV Surveillance Report).Twenty two (67%) were male and their mean age was 39.3 +/-12.8yrs; 18 (54%) were Caucasian, 13 (39%) African-American, and 2 (6%) were of other ethnicities.Seven (21%) had HBV co-infection, 2 (6 %) had HCV co-infection, 6 % reported a recent history of alcohol abuse.None had a recent history of IDU; 19/33 (57%) were receiving an antiretroviral agent at study enrollment.RUCAM scores were performed on 14 suspect drugs in the 11 DILI cases that were categorized into: highly probable (1), probable (5), possible (4), and unlikely (4).Implicated agents in the DILI cases included 7 combination antiretroviral agents given for 5-30 days, 2 trimethoprim-sulfamethoxazole cases, and 5 due to other drugs including voriconazole (1), sulfadiazine (2), duloxetine (1), and clarithromycin (1).Twenty four (73%) were alive at 3 weeks including 6 (18%) who had undergone transplantation (2 APAP, 1 DILI, 1 AIH, 1 HBV, 1 HAV).Six of 9 pts that died at 3 weeks were due to DILI.The APAP pts had a 3-week spontaneous survival rate of 78% compared to only 36% in the DILI group.Nine pts were seen at a mean of 26 months after enrollment which included 5 LT recipients (1 APAP, 1 DILI, 3 Other)and 4 spontaneous survivors (2 APAP, 1 DILI, 1 Other).At follow-up, 7 (78%) had normal liver biochemistries and none of the LT recipients had experienced rejection or alloimmune hepatitis.CONCLUSIONS: DILI is over-represented in HIV+ ALF patients in comparison to the overall ALFSG cohort (33% vs 10%), but is not limited to anti-retrovirals.The small number of ALF HIV + LT recipients have generally done well, indicating that LT can be offered to selected HIV+ ALF patients.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,006 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».