HIV对HIV/HCV共感染患者丙型肝炎病程进展的影响  

Influence of HIV infection on hepatitis C progress in patients co-infected with HIV/HCV

作　　者：刘金花[1] 孙焕芹[1] 赵艳[1] 孙焕焕[1] 乔桂芳[1] 徐杰[1] 刘宁[1] 覃岭[1] 李昂[1] 江娜[1] 张永宏[1] 

机构地区：[1]首都医科大学附属北京佑安医院,北京100069

出　　处：《中华流行病学杂志》2015年第7期738-742,共5页Chinese Journal of Epidemiology

基　　金：国家自然科学基金（81271842）;北京市自然科学基金（7132098）;首都卫生发展科研专项（首发2011-2018-06）;北京市科技计划项目（D131100005315005）

摘　　要：目的：探讨HIV感染对HIV/HCV共感染患者病情进展的影响及免疫机制。方法研究对象为28例HIV/HCV共感染者及12例HCV单独感染者。外周血生化检测及超声Fibro-Scan评估肝脏功能及纤维化程度，采用PCR-荧光探针法检测外周血HCV病毒载量，运用流式细胞技术检测外周血Treg/CD4^＋T淋巴细胞百分率。结果 HIV/HCV共感染组ALT及碱性磷酸酶（ALP）水平分别为（76.16±81.248）U/L、（24.5071±8.194）g/L，明显高于HCV单独感染组[（27.4750±13.985）U/L、（16.9667±7.189）g/L]，差异具有统计学意义，P值分别为0.012、0.009。HIV/HCV共感染组患者肝脏纤维化指标E值为5.9500～5.8250 Kpa，与HCV单独感染患者（5.1500～1.0500 Kpa）相比有升高趋势，P＝0.077。HIV/HCV共感染者、HCV单独感染者HCV载量及病毒清除率分别为（6.4768～5.3434）lg copy/ml及32.14%、（1.6990～2.6815）lg copy/ml及75.00%，HIV/HCV共感染组HCV载量明显高于HCV单独感染组，HCV清除率低于HCV单独感染组，P值分别为0.012及0.032。HIV/HCV共感染组Treg/CD4^＋T淋巴细胞百分率为（7.4600%～2.2875%），高于HCV单独感染组（5.9650%～2.1050%），差异有统计学意义（P＝0.032）。并且Treg/CD4^＋T淋巴细胞百分率与HCV载量具有明显相关性（ρ＝0.350，P＝0.027），而HCV载量与肝脏纤维化程度E值存在相关性（ρ＝0.487，P＝0.001）。结论 HIV/HCV共感染加速丙型肝炎病情进展，而Treg细胞与丙型肝炎病情进展相关。Objective To understand the influence of HIV infection on hepatitis C progress in patients co-infected with HIV and hepatitis C virus （HCV） and related immune mechanism. Methods Twenty eight patients co-infected with HIV/HCV and 12 patients with simplex HCV infection were enrolled. The liver function and hepatic fibrosis progress were evaluated by detecting peripheral blood and with Fibro-Scan. The viral load of HCV was detected by using real time quantitative PCR. And the percentage of Treg/CD4 ＋T lymphocyte cell was tested by using flow cytometry. Results The levels of ALT and ALP in HIV/HCV co-infection group were （76.16 ± 81.248）U/L,（24.507 1 ± 8.194）g/L respectively,higher than those of simplex HCV infection group [（27.475 0±13.985）U/L,（16.966 7±7.189）g/L],the differences were statistical significant. P value was 0.012 and 0.009 respectively. The liver fibrosis index in HIV/HCV co-infection group was 5.950 0-5.825 0 Kpa,higher than that in simplex HIV infection group（5.150 0-1.050 0 Kpa）,and the difference was nearly statistical significant（P=0.077）. The HCV viral load in HIV/HCV co-infection group was（6.476 8-5.343 4）lg copy/ml,higher than that in simplex HCV infection group[（1.699 0-2.681 5）lg copy/ml],and the rate of HCV clearance in HIV/HCV co-infection group was 32.14%, lower than that in simplex HCV infection group（75.00%）. P value was 0.012 and 0.032 respectively. The percentage of Treg/CD4^＋T lymphocyte cell in HIV/HCV co-infection group was （7.460 0%-2.287 5%）,higher than that in simplex HCV infection group （5.965 0%-2.105 0%）,and the difference was significant （P=0.032）. The percentage of Treg/CD4 ＋ T lymphocyte cell was significantly related with HCV viral load（ρ=0.350,P=0.027）,and HCV viral load was significantly related with the liver fibrosis index（ρ=0.487,P=0.001）. Conclusion HIV infection could accelerate the progress of hepatitis C,and Treg cells were involved in this progress.

关 键 词：艾滋病病毒 丙型肝炎病毒 共感染 肝内调节性T细胞 

分 类 号：R512.6[医药卫生—内科学] R512.91[医药卫生—临床医学]