HIV合并感染加速HCV白发清除者抗-HCV抗体衰减  

Accelerated decline in anti-HCV antibody levels in spontaneous HCV seroconverters with HIV co-infection

作　　者：李渊韬 吕琳婷 马尔马尔·托乎塔尔别克 谢喆 梁华[2] 沈弢 Li Yuantao;Lyu Linting;Maermaer Tuohutaerbieke;Xie Zhe;Liang Hua;Shen Tao(Department of Microbiology, School of Basic Medical Sciences, Peking University Health Science Center, Beijing 100191, China;National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China)

机构地区：[1]北京大学医学部基础医学院病原生物学系,100191 [2]中国疾病预防控制中心性病艾滋病预防控制中心,北京102206

出　　处：《中华微生物学和免疫学杂志》2018年第6期456-460,共5页Chinese Journal of Microbiology and Immunology

基　　金：国家“十三五”重大科技专项（2017ZX10202101-003,2018ZX10731101-001-008,2018ZX09739002-003）;传染病预防控制国家重点实验室课题（2015SKLID506）

摘　　要：目的了解HIV合并感染对HCV自发清除患者抗-HCV抗体水平变化的影响。方法2009年和2017年分别对河南省上蔡县王营村有既往献血史人群抗-HCV抗体水平进行回顾性研究，根据2009年调查结果将抗-HCV抗体阳性人群分为4组：HCV慢性感染组（HCVc）、HCV自发清除组（HCVr）、HIV阳性的HCV慢性感染组（HIV＋HCVc）、HIV阳性的HCV自发清除组（HIV＋HCVr）。2017年随访中剔去失访人群、HCV治疗人群和HCV自发清除再感染人群，每组随访人数分别为：HCVc组65人、HCVr组34人、HIV＋HCVc组44人、HIV＋HCVr组24人。对上述4组2009年抗-HCV抗体水平进行横向比较，以及对2009—2017年4组抗-HCV抗体水平变化进行纵向比较分析。 结果2009年横向比较显示，无论HIV是否合并感染，慢性感染组抗-HCV抗体水平均显著高于自发清除组。2009—2017年HCVc和HIV＋HCVc组的抗-HCV抗体水平无明显变化，但HCVr和HIV＋HCVr组的抗-HCV抗体水平均呈显著衰减趋势（P〈0.0001）；HIV＋HCVr组的抗-HCV抗体衰减程度高于HCVr组（P＝0.0039）；HCVr组（r＝－0.5277，P＝0.0017）与HIV＋HCVr组（r＝－0.7532，P〈0.0001）初始抗-HCV抗体水平与抗-HCV抗体衰减幅度呈负相关；HIV＋HCVr组的抗-HCV抗体变化水平与2009年CD4＋T细胞计数基数水平呈负相关（r＝－0.5638，P＝0.0041）；HIV＋HCVr组与HCVr组的抗-HCV阴转率差异有统计学意义（P＝0.0275）。结论HIV合并感染加速HCV自发清除患者抗-HCV抗体衰减，提示在大规模流行病学调查时，HIV感染人群的抗-HCV抗体阳性比例可能被低估。ObjectiveTo investigate the influence on anti-HCV antibody levels in spontaneous HCV seroconverters co-infected with HIV. MethodsA retrospective study was conducted on people with a history of blood donation in Wangying Village, Shangcai County, Henan Province in 2009 and 2017.According to the infection status in 2009, patients who were positive for anti-HCV antibody were divided into four groups： HIV-negative chronic HCV infection group （HCVc）, HIV-negative spontaneous HCV clearance group （HCVr）, HIV-positive chronic HCV infection group （HIV＋ HCVc）, HIV-positive spontaneous HCV clearance group （HIV＋ HCVr）. All patients were followed up in 2017 and those who were lost to follow-up, received HCV treatment or were reinfected with HCV （only for those of HCV seroconverters） were excluded from this study.Altogether 167 patients met the inclusion criteria （HCVc： n=65; HCVr： n=34; HIV＋ HCVc： n=44; HIV＋ HCVr： n=24）. A horizontal comparison of anti-HCV antibody levels among the above four groups in 2009 and a longitudinal comparison of changes in anti-HCV antibody in each group from 2009 to 2017 were respectively conducted.ResultsThe horizontal comparison indicated that the levels of anti-HCV antibody were higher in chronic HCV-infected patients than in HCV seroconverters no matter whether they were co-infected with HIV or not （both P〈0.000 1）. After comparison of anti-HCV antibody titers in 2017 and 2009, no significant changes were found in HCVc or HIV＋ HCVc group.The levels of anti-HCV antibody in HCVr and HIV＋ HCVr groups decreased significantly from 2009 to 2017 （both P〈0.000 1）. HIV＋ HCVr group showed a faster decline in anti-HCV antibody level than HCVr group （P=0.003 9）. Significant negative correlations between the decline speed in anti-HCV antibody sample/cut-off （S/CO） values and the initial anti-HCV antibody S/CO values （in 2009） were found in both HCVr （r=-0.517 7, P=0.001 7） and HIV＋ HCVr groups （r=-0.753 2, P〈0.000 1）. The

关 键 词：抗-HCV抗体 HCV自发清除 HIV合并感染 抗体衰减 相关性 

分 类 号：R512.63[医药卫生—内科学] R512.91[医药卫生—临床医学]