HIV感染者合并转氨酶升高的研究进展
Progress in the Study of Elevated Transaminases in HIV-Infected Patients
DOI: 10.12677/acm.2026.162537, PDF,   
作者: 金在嫒, 蔡 佳*：重庆医科大学附属第一医院感染科，重庆
关键词: HIV感染者；转氨酶升高；病因分析；HIV-Infected Patients； Elevated Transaminases； Etiological Analysis
摘要: 人类免疫缺陷病毒(human immunodeficiency virus, HIV)患者的血清转氨酶(包括丙氨酸氨基转移酶(Alanine Aminotransferase, ALT)及天冬氨酸氨基转移酶(Aspartatee Aminotransferase, AST))的升高通常反映肝细胞损伤。本文系统综述了HIV感染者转氨酶升高的主要危险因素，包括合并乙型肝炎病毒(hepatitis B virus, HBV)或丙型肝炎病毒(hepatitis C virus, HCV)共感染、抗逆转录病毒治疗(antiretroviral treatment, ART)药物肝毒性、代谢相关脂肪性肝病(metabolic dysfunction-associated fatty liver disease, MAFLD)等。研究表明，持续转氨酶升高与肝纤维化进展及肝硬化风险增加存在显著相关性。本文通过分析现有循证医学证据，结合血清学检测、影像学评估及瞬时弹性成像技术进行综合诊断，强调对HIV感染者实施定期肝功能监测、优化ART方案和多学科协同管理的临床路径，为改善肝脏预后提供理论依据和实践指导。
Abstract: Elevated serum aminotransferases (including alanine aminotransferase (ALT) and aspartatee aminotransferase (AST)) in patients with human immunodeficiency virus (HIV) usually reflect hepatocellular damage. This paper systematically reviews the major risk factors for transaminase elevation in HIV-infected patients, including co-infection with hepatitis B virus (HBV) or hepatitis C virus (HCV), hepatotoxicity of antiretroviral treatment (ART) drugs, and metabolic dysfunction-associated fatty liver disease (MAFLD). Studies have shown a significant correlation between persistent transaminase elevation and progression of liver fibrosis and increased risk of cirrhosis. By analysing the available evidence-based medical evidence, this article suggests a comprehensive diagnosis combining serological testing, imaging assessment and transient elastography, and emphasises a clinical pathway of regular liver function monitoring, optimal ART regimen and multidisciplinary collaborative management for HIV-infected patients, which provides theoretical basis and practical guidance to improve the hepatic prognosis of such patients.
文章引用：金在嫒, 蔡佳. HIV感染者合并转氨酶升高的研究进展[J]. 临床医学进展, 2026, 16(2): 1495-1501. https://doi.org/10.12677/acm.2026.162537

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