不同HAART方案对HIV合并HCV感染患儿肝功能和HIV载量的影响  

The effect of different HAART regimens on liver function and HIV load of HIV infected children with HCV co-infection

作　　者：饶和平[1] 靳昌忠[2] 金祥宁[3] 方美新[4] 王炜[5] 卢伟力[6] 

机构地区：[1]衢州职业技术学院医学院,浙江衢州324000 [2]浙江大学医学院附属第一医院传染病诊治国家重点实验室,杭州310003 [3]金华职业技术学院医学院,浙江金华321000 [4]浙江大学医学院附属儿童医院内科,杭州310003 [5]浙江省衢州市疾病预防控制中心艾滋病研究室,324000 [6]浙江省衢州市人民医院感染科,324000

出　　处：《重庆医学》2017年第15期2045-2047,共3页Chongqing medicine

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：目的探讨高效抗逆转录病毒治疗(HAART)不同治疗方案对人类免疫缺陷病毒(HIV)合并丙型肝炎病毒(HCV)感染患儿肝功能、HIV载量、CD4^+T细胞的影响。方法 40例患者分为齐多夫定(AZT)+拉米夫定(3TC)+奈韦拉平(NVP)联合组13例(A组),AZT+3TC+依非韦伦(EFV)联合组16例(B组),司他夫定(D4T)+3TC+EFV治疗组5例(C组),D4T+3TC+NVP治疗组6例(D组)。检测比较4组治疗前后肝功能、HIV载量、CD4^+T细胞。结果 HAART治疗前肝功能异常8例(20%),均为1级肝损害。4组治疗后A、B组ALT、AST上升(P<0.01),C组治疗后AST上升(P<0.01)。HAART治疗后各组CD4^+T细胞明显升高(P<0.01),HIV-RNA病毒载量明显减低(P<0.01)。治疗前后HCV-RNA载量变化差异无统计学意义(P>0.05)。结论 HIV合并HCV感染患儿HAART不同治疗方案可增加肝损害,但对HAART治疗效果影响有限。Objective To investigate the effect of different HAART regimens on liver function,viral load and CD4^＋T cells of HIV infected children with HCV co-infection.Methods A total of 40 patients were divided into 4groups：13cases in AZT＋3TC＋NVP group（group A）,16 cases in AZT＋3TC＋EFV group（group B）,5cases in D4T＋3TC＋EFV group（group C）and 6cases in D4T＋3TC＋NVP group（group D）.Liver function,viral load and CD4^＋T cells of patients in 4groups were compared between before and after HAART.Results Eight patients（20%）had abnormal liver function before HAART treatment,and all of them had1 level of liver damage.After receiving HAART,levels of ALT and AST were increased in group A and B（P〈0.01）;AST levels were increased in group C（P〈0.01）.CD4^＋T counts were all increased and HIV viral loads were decreased in 4groups（P〈0.01）.There was no significant difference in RNA HCV load before and after HAART treatment（P〈0.05）.Conclusion Different HAART regimens can increase the liver damage in HIV infected children co-infected with HCV,but have little effect on the treatment efficiency of HAART regimens.

关 键 词：HIV 肝炎 丙型 病毒载量 抗逆转录病毒治疗 高效 肝功能 

分 类 号：R725.1[医药卫生—儿科]