Operated hepatocellular carcinoma in two HIV- and HCV-positive hemophilic patients.
Some hemophilic patients in Japan suffer from infections with both human immunodeficiency virus (HIV) and hepatitis virus because they received contaminated nonheated blood products. Coinfection with HIV appears to accelerate the course of chronic hepatitis. Although powerful antiviral therapy was introduced as HIV treatment and the prognosis of HIV patients was dramatically improved, the risk of rapid progression of hepatitis and carcinogenesis remains for the patients. Recently, we performed surgery for hepatocellular carcinoma (HCC) in two hemophilic patients with HIV and hepatitis C virus (HCV) coinfection. Case 1 was a 52-years-old man who suffered from liver cirrhosis, hypersplenism, and hyperammonemia due to portosystemic shunt. A recent abdominal computed tomography (CT) scan had revealed a low-density area in segment VI of the liver. Splenectomy and partial resection of the liver were performed. Case 2 was a 66-year-old man who had been diagnosed with chronic hepatitis at age 50, and HIV infection at age 52 years. When his serum alpha-fetoprotein level was increased, CT scan of the liver revealed a mass in segment VIII. Subsegmentectmy of the liver was performed. Although the CD4 value in each patient was lower than 200 micro l, the operations were safely carried out and no major complication occurred. Because the chance of encountering HCC patients infected with HIV and HCV is increasing in Japan, we should consider the perioperative care of these patients, as well as the protection of medical workers against HIV infection.
Narushima
Yoichi
Y
Division of Hepatobiliary-Pancreatic Surgery, Department of Surgery, Sendai National Hospital, 2-8-8 Miyagino, Miyagino-ku, Sendai, 983-8520, Miyagi, Japan.
Ishiyama
Shuichi
S
Kawashima
Kazuki
K
Shimamura
Hiromune
H
Yamaki
Takayuki
T
Yamauchi
Hidemi
H
D000368:Aged; D018791:CD4 Lymphocyte Count; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery; D015897:Comorbidity; D015658:HIV Infections / Q000453:epidemiology*; D006467:Hemophilia A / Q000453:epidemiology*; D006526:Hepatitis C / Q000453:epidemiology*; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011859:Radiography