重庆地区123例静脉注射吸毒的HIV/HCV共感染者临床特征分析  

Clinical characteristics of 123 HIV/HCV co-infected cases among intravenous drug users in Chongqing

作　　者：刘敏[1] 鲁雁秋 李奇穗[1] 何小庆 李同心[1] 王静[1] LIU Min;LU Yan-qiu;LI Qi-sui;HE Xiao-qing;LI Tong-xin;WANG Jing(Second Department of Communicable Diseases, Chongqing Public Health Medical Center,400036,China)

机构地区：[1]重庆市公共卫生医疗救治中心感染二科,400036

出　　处：《传染病信息》2018年第6期525-528,共4页Infectious Disease Information

基　　金：重庆市卫生计生委医学科研项目(2017MSXM119)

摘　　要：目的了解重庆地区静脉注射吸毒(吸毒)的HIV感染者合并HCV感染发生率及临床特征,探讨吸毒对HIV/HCV共感染者病情的影响。方法收集吸毒的HIV/HCV共感染者资料,了解其肝功能及血常规情况,分析出现肝功能异常及贫血的相关因素;分析吸毒对HIV/HCV共感染者病情的影响。结果 (1) 149例吸毒的HIV感染者中合并HCV感染123例(82.6%),感染的HCV中以基因3型最常见(69.0%);87.0%的HIV/HCV共感染者合并其他病原菌感染,其中结核分枝杆菌最常见(56.1%);14.6%的HIV/HCV共感染者规律抗HIV治疗,8.1%抗HCV治疗,短期存活率为56.1%。(2)吸毒的HIV/HCV共感染者中有67.5%和72.4%的患者分别伴肝功能异常和贫血,贫血组中女性所占比例较非贫血组高,CD4+T细胞计数较非贫血组低,HIVRNA定量较非贫血组高(P均<0.05)。(3)有吸毒史的HIV/HCV共感染者与无吸毒史的HIV/HCV共感染者比较,前者HGB、ALB指标降低更明显,后者肝功能异常程度更重(P均<0.05)。结论重庆地区吸毒的HIV感染者合并HCV感染率高,以HCV基因3型最常见;该类患者易合并结核菌感染,易出现肝功能异常及贫血现象,治疗依从性差,病死率高;贫血与性别、CD4+T细胞计数、HIV RNA定量存在相关性;有吸毒史的HIV/HCV共感染者营养状况较非吸毒患者差。Objective To explore the incidence and clinical characteristics of HCV/HIV co-infected patients in intravenous drug users in Chongqing,and the effect of drug use on HIV/HCV co-infection.Methods Clinical data of HIV/HCV co-infected patients with drug abuse were retrospectively analyzed,to understand the situation of liver function and blood routine,investigate the influential factors of liver dysfunction and anemia,and analyze the influence of drug abuse on the disease condition of HIV/HCV coinfected patients.Results Among the149HIV infected cases,123cases had combined HCV infection(82.6%).The most common type was gene3(69.0%).Among HIV/HCV co-infection patients87.0%were accompanied with other pathogens,mycobacterium tuberculosis was the most common(56.1%),14.6%of HIV/HCV co-infection received regular anti-HIV treatment,8.1%received anti-HCV treatment and the short-term survival rate was56.1%.Among the HIV/HCV co-infected patients,67.5%and72.4%of the patients had liver dysfunction and anemia,respectively.The proportion of women in the anemia group was higher than that in the non-anemia group,and the CD4^+T cell count was lower,while the HIV-RNA level was higher than that in the non-anemia group(P<0.05).Compared with HIV/HCV co-infected patients without the history of drug abuse,those HIV/HCV co-infected patients with a history of drug abuse showed obviously decreased HGB and ALB,and severe abnormal liver function(P<0.05).Conclusions HIV/HCV co-infection rate is very high among drug users in Chongqing area.The most common type is HCV gene type3.These patient is susceptible to tuberculosis infection,liver dysfunction and anemia,with a poor treatment compliance and high mortality.Anemia is related to gender,CD4^+T cell count,and HIV RNA.Drug abuse can aggravate the HIV/HCV co-infection.

关 键 词：人类免疫缺陷病毒 丙型肝炎病毒 合并感染 静脉注射吸毒 

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