HIV/HBV合并感染患者抗病毒治疗的效果及与病毒载量之间相关性分析  

Analysis on the effect of antiviral therapy and correlation with viral load in patients with HIV/HBV co-infection

作　　者：黄成军 程书权 田群 林君 HUANG Chengjun;CHENG Shuquan;TIAN Qun;LIN Jun(Department of Liver Disease,the Third People's Hospital of Guilin,Guangxi Zhuang Autonomous Region,Guilin541001,China;Department of Liver Disease,Ganzhou Fifth People's Hospital,Jiangxi Province,Ganzhou341000,China)

机构地区：[1]桂林市第三人民医院肝病科,广西桂林541001 [2]江西省赣州市第五人民医院肝病科,江西赣州341000

出　　处：《中国医药导报》2020年第28期28-31,共4页China Medical Herald

基　　金：“十三五”艾滋病和病毒性肝炎等重大传染病防治专项(2018ZX10302104-001);广西壮族自治区卫生和计划生育委员会自筹经费科研课题(Z2015082)。

摘　　要：目的探讨人类免疫缺陷病毒/乙型肝炎病毒(HIV/HBV)合并感染患者的抗病毒治疗效果及与病毒载量之间的相关性。方法选取2017年1月—2018年12月广西壮族自治区桂林市第三人民医院感染科HBV、HIV感染的患者147例为研究对象,根据感染类型将患者分为HBV组49例、HIV组50例、HIV/HBV组48例。比较治疗前后三组肝、肾功能指标水平与HIV核糖核酸(HIV-RNA)及HBV脱氧核糖核酸(HBV-DNA)之间的相关性。结果HBV组治疗24周后丙氨酸转氨酶(ALT)、总胆红素(TBil)、直接胆红素(DBil)水平低于治疗12周后,治疗48周后ALT、TBil、DBil水平低于治疗24周后,差异均有统计学意义(均P<0.05)。HIV组治疗12、24周后的TBil、DBil水平高于治疗前;治疗24周后的天冬氨酸转氨酶(AST)水平低于治疗前;治疗48周后AST、TBil、DBil水平低于治疗24周后,差异有统计学意义(P<0.05)。HIV/HBV组治疗12周后DBil水平低于治疗前,治疗24周后DBil水平低于治疗12周后,治疗48周后DBil水平低于治疗24周后,差异有统计学意义(P<0.05)。治疗24周后HIV/HBV组的HBV-DNA水平高于HBV组,差异有统计学意义(P<0.05)。治疗24周后及48周后HIV/HBV组的HIV-RNA水平高于HIV组,差异有统计学意义(P<0.05)。结论HIV/HBV合并感染抗病毒对肝功能恢复有效,但清除HIV、HBV病毒较困难。Objective To investigate the effect of antiviral therapy and correlation with viral load in patients with human immuncodeficiency virus/hepatits B virus(HIV/HBV)co-infection.Methods From January 2017 to December 2018,147 patients with HBV and HIV infection in the Department of Infectious Diseases of the Third People's Hospital of Guilin,Guangxi Zhuang Autonomous Region were selected as the research subjects.According to the type of infection,the patients were divided into three groups:49 cases in HBV group,50 cases in HIV group,and 48 cases in HIV/HBV group.Prospective analysis was conducted to calculate the correlation between liver and kidney function indexes of three groups of patients before and after treatment with HIV ribonucleic acid(HIV-RNA)and HBV deoxyribonucleic acid(HBV-DNA).Results The levels of alanine aminotransferase(ALT),total bilirubin(TBil)and direct bilirubin(DBil)in the HBV group after 24 weeks of treatment were lower than those after 12 weeks,and the levels of ALT,TBil and DBil after 48 weeks of treatment were lower than those after 24 weeks of treatment,and the differences were statistically significant(all P<0.05).The levels of TBil and DBil in the HIV group after 12 and 24 weeks of treatment were higher than those before treatment,aspartate aminotrransferase(AST)levels after 24 weeks of treatment were lower than those before treatment,after 48 weeks of treatment,the levels of AST,TBil and DBil were lower than those after 24 weeks of treatment,and the differences were statistically significant(P<0.05).After 12 weeks of treatment,the DBil level in the HIV/HBV group was lower than that before treatment,after 24 weeks of treatment DBil level was lower than that after 12 weeks of treatment,and that after 48 weeks of treatment was lower than that after 24 weeks of treatment,and the differences were statistically significant(P<0.05).After 24 weeks of treatment,the HBV-DNA level of the HIV/HBV group was higher than that of the HBV group,and the difference was statistically significant(P<0.05).Aft

关 键 词：人类免疫缺陷病毒 乙型肝炎病毒 抗病毒治疗 肝肾功能 

分 类 号：R512.6[医药卫生—内科学]