HIV/HCV重叠感染患者肝脏功能进展原因分析  

The factor analysis of accelerating liver function failure in the patients with human immunodeficiency virus and hepatitis C virus coinfection

作　　者：张永宏[1] 陈新月[1] 蒋岩[2] 肖瑶[2] 刘震[2] 龙小山 吴昊[1] 

机构地区：[1]首都医科大学附属北京佑安医院,北京100054 [2]中国疾病预防控制中心性病艾滋病中心,北京100050

出　　处：《临床肝胆病杂志》2004年第5期269-271,共3页Journal of Clinical Hepatology

基　　金：国家十五科技攻关资助项目 (课题号 2 0 0 1BA70 5B0 1)

摘　　要：探讨HIV/HCV重叠感染患者肝脏功能进展的原因。回顾性比较HIV/HCV重叠感染患者和单独HCV感染患者两组的肝脏功能、病理情况、感染时间、免疫功能及综合分析HCVRNA定性检测与HCV抗体检测在两组中的异同。HIV/HCV重叠感染患者中肝功异常者占 5 8 5 % ,HCV感染组为 85 5 % ,肝功损伤程度亦较后者轻微 (P<0 0 5 ) ;两组患者在肝脏病理炎症活动和纤维化程度方面差异无显著性 (P =0 187,0 95 4 ) ;而重叠感染患者进展到肝功能异常的时间较单独HCV感染者提前 8年 (P <0 0 0 1) ;免疫功能方面 (CD+ 4 T、CD+ 8T)重叠感染者组与单独HCV感染者组比较 ,差异非常显著 (P <0 0 0 1;P <0 0 0 1) ;HCVRNA(+)同时HCV抗体 (+)的人数与HCVRNA(+)同时HCV抗体 (- )的人数比较在重叠感染组为 5 2∶9例 ,在HCV感染组 4 4∶1例 ,两组间差异显著P =0 0 4 3。HIV/HCV重叠感染可加速丙型病毒性肝炎的进展 ,可能与HIV对机体的细胞免疫。To study the causes of accelerating liver function failure in the patients with HIV/HCV coinfection. The patients were divided into two groups, HIV/HCV coinfection group (n=82) and simple HCV infection group (n=62). A retrospective study was designed to compare liver function, pathology of liver tissue, the time of infection, immune function, qualitative assay of HCV-RNA and HCV antibody between the two groups. Although there was significant difference between two groups on liver function (P<0.05),but there were no significant differences in degree of inflammation of liver and degree of liver fibrosis in the two groups (P=0.187,0.954). However, the time when liver abnormality occurred in the patients with HIV/HCV coinfection was earlier 8 years than those with simple HCV infection (P<0.001).There were significant differences between the two groups on the count of CD + 4T and CD + 8T(P<0.001,P<0.001).Comparing the cases of HCVRNA(+) and anti-HCV(+) with the cases of HCVRNA(+)and anti-HCV(-), we found that the ratio was 52 to 9 in the group of HIV/HCV coinfection, and 44 to 1 in the group of simple HCV infection. The difference was statistically significant between the two groups (P=0.043). HIV/HCV coinfection can accelerate deterioration of hepatitis C, which maybe due to the effect of HIV on cellular immunity and humoral immunity.

关 键 词：重叠感染 HIV 患者 HCV感染 肝脏功能 HCVRNA HCV抗体 定性检测 加速 机体 

分 类 号：R512.6[医药卫生—内科学]