Idiopathic Portal Hypertension in Patients With HIV Infection Treated With Highly Active Antiretroviral Therapy

Chang, Pik‐Eu; Miquel, Rosa; Blanco, José-Luís; Laguno, Montserrat; Bruguera, Miguel; Abraldes, J.G.; Bosch, Jaime; García-Pagán, Juan Carlos

doi:10.1038/ajg.2009.165

Cited by 84 publications

(93 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Concerning PVT, data on its prevalence vary widely between studies. 2,3,8,10,11 Moreover, the efficacy of anticoagulant treatment in IPH patients with PVT has never been documented.…”

mentioning

confidence: 99%

“…Immunological disorders, recurrent infections, trace metals, medications, and prothrombotic factors have been considered causal features. [3][4][5] Recently, several studies have reported on the association between human immunodeficiency virus (HIV) infection treated with antiretroviral therapy and development of IPH. 3 Patients with IPH usually present with signs and symptoms of portal hypertension (PH), such as splenomegaly, thrombocytopenia, and variceal bleeding (VB).…”

mentioning

confidence: 99%

“…[3][4][5] Recently, several studies have reported on the association between human immunodeficiency virus (HIV) infection treated with antiretroviral therapy and development of IPH. 3 Patients with IPH usually present with signs and symptoms of portal hypertension (PH), such as splenomegaly, thrombocytopenia, and variceal bleeding (VB). 4 Because of limited information on the natural history of varices in IPH, current recommendations for prophylaxis and treatment of variceal hemorrhage are those applied in patients with cirrhosis.…”

mentioning

confidence: 99%

“…The most commonly reported characteristics range from sinusoidal dilatation, phlebosclerosis, and portal fibrosis to nodular regenerative hyperplasia. 3 The pathophysiological mechanisms causing IPH remain largely unknown. Immunological disorders, recurrent infections, trace metals, medications, and prothrombotic factors have been considered causal features.…”

mentioning

confidence: 99%

“…[1][2][3] Histological features of IPH involve a wide spectrum of nonspecific changes. The most commonly reported characteristics range from sinusoidal dilatation, phlebosclerosis, and portal fibrosis to nodular regenerative hyperplasia.…”

mentioning

confidence: 99%

See 4 more Smart Citations

Idiopathic portal hypertension: Natural history and long-term outcome

et al. 2014

Self Cite

View full text Add to dashboard Cite

Idiopathic portal hypertension (IPH) is a rare cause of intrahepatic portal hypertension. Data on natural history and prognosis of IPH are limited. We sought to describe the complications and long-tem outcome of IPH by retrospectively studying 69 biopsyproven cases of IPH. Mean duration of follow-up was 6.7 6 4.6 years. All patients had evidence of portal hypertension (PH) at diagnosis, and 42% were symptomatic. Variceal bleeding (VB) was the most common manifestation. In those without bleeding at diagnosis, 74% had varices at first endoscopy. In those with large varices, the 1-year probability of first bleeding despite primary prophylaxis was 9%. The 1-year probability of rebleeding was 22%. Ascites and hepatic encephalopathy was documented in 26% and 7% of patients, respectively, at least once during the clinical course. The 1-year probability of developing portal vein thrombosis (PVT) was 9%, and 53% of patients receiving anticoagulation achieved recanalization. Human immunodeficiency virus (HIV) infection and VB at diagnosis were the independent predictors of PVT. Seven patients died (6 as a result of an IPH-related cause) and 2 were transplanted. Probability of liver transplantation-free survival was 82% at 10 years. Presence of a severe associated disorder and ascites as a presenting symptom were associated with poor survival. Conclusion: Variceal bleeding is a major complication of IPH. Using, in IPH patients, the same management approach for PH as in cirrhosis is safe and maintains a low incidence of first bleeding and rebleeding in IPH patients. PVT is a frequent complication, particularly in those with HIV infection. Despite several complications, overall survival of patients with IPH is considerably good. (HEPATOLOGY 2014;59:2276-2285

show abstract

“…Concerning PVT, data on its prevalence vary widely between studies. 2,3,8,10,11 Moreover, the efficacy of anticoagulant treatment in IPH patients with PVT has never been documented.…”

mentioning

confidence: 99%

mentioning

confidence: 99%