艾滋病合并HBV/HCV感染患儿HAART治疗后肝功能及病毒载量变化  

Study on liver function and viral lood of pediatric AIDS patients with HBV / HCV co-infection receiving HAART

作　　者：饶和平[1] 方美新[2] 王炜[3] 卢伟力[4] 姚水洪[1] 叶剑华 

机构地区：[1]衢州职业技术学院医学院,衢州324000 [2]浙江大学医学院附属儿童医院血液科,杭州310009 [3]衢州市疾病预防控制中心艾滋病研究室,衢州324000 [4]衢州市人民医院感染科,衢州324000 [5]衢江区疾病预防控制中心,衢州324000

出　　处：《中国免疫学杂志》2015年第10期1385-1388,共4页Chinese Journal of Immunology

基　　金：浙江省公益性技术应用研究计划项目(2014C33252);衢州市科技计划项目(2013Y019)

摘　　要：目的:观察艾滋病合并HBV/HCV感染患儿HAART治疗后肝功能、病毒载量、CD4+T细胞变化特点,探讨艾滋病患儿合并HBV/HCV感染对HAART效果的影响。方法:单纯HIV感染95例(A组),HIV合并HBV感染9例(B组),HIV合并HCV感染23例(C组)。患儿均接受HAART治疗2年左右,检测治疗前后三组肝功能、病毒载量、CD4+T细胞,并进行比较。结果:HAART治疗后2级(100<ALT≤200μ/L且TBIL≤51.25μmol/L)以上肝毒性肝损伤26例(20.5%),三组比较有统计学差异(χ2=37.94,P<0.01),合并HCV感染组明显高于单纯感染组(χ2=12.60,P<0.01)。治疗后三组在ALT有统计学差异(P<0.05),且C组在ALT与TBIL二项明显高于A组(t值分别为10.53与1.37,P<0.05)。HAART治疗后各组CD4+T细胞明显升高(P<0.01),病毒载量(HIV-RNA)明显减低(P<0.01),治疗后三组间CD4+T细胞及病毒载量比较无统计学意义(P>0.05)。结论:HIV合并HBV/HCV感染可增加肝毒性肝损伤,但对HAART治疗效果的影响有限。Objective：To investigate the change of liver function,viral load and CD4＋T count in pediatric AIDS patients with HBV/HCV co-infection after HARRT therapy,and explore the effect of HBV/HCV co-infection on HAART.Methods：95 pediatric AIDS patients without HBV/HCV co-infection （ group A） ,9 pediatric AIDS patients with HBV co-infection （ group B） and 23 pediatric AIDS patients with HCV co-infection （ group C） who received HAART for 2 year were enrolled.Liver function,viral load and CD4＋T count were detected before and after HAART.Results：After HAART for 2 years,26 patients （20.5%） were found with liver injury of grade 2 （100〈ALT≤200 U/L and TBIL≤51.25μmol/L） （χ2=37.94,P〈0.01） ,more patients with liver injury of grade 2 in group C than in group A （χ2=12.60,P〈0.01）.ALT and TBIL of patients in group C was much higher than that in group A （t value was 10.53 and 1.37,P〈0.05）.CD4＋T cell counts were increased （P〈0.01） and viral load （HIV-RNA） was decreased （P〈0.01） after two years of HAART, no difference was found among three groups of patients （ P〉0.05 ） .Conclusion： Co-infection of HBV/HCV can aggravate the liver damage of HIV-1 infected children,but has no significant effect on HAART.

关 键 词：儿童艾滋病 肝损伤 病毒载量 

分 类 号：R392[医药卫生—免疫学]