昆明地区HIV/HCV共感染者HCV病毒载量及免疫生化指标的研究  

Study on HCV viral load and immune biochemical indexes of HIV/HCV co-infected patients in Kunming area

作　　者：朱燕涛 亢丽娟 张米 李健健 刘俊仪 刘家法 谢祺 杨开林 张念 王佳丽 ZHU Yantao;KANG Lijuan;ZHANG Mi;LI Jianjian;LIU Junyi;LIU Jiafa;XIE Qi;YANG Kailin;ZHANG Nian;WANG Jiali(Department of Laboratory,Yunnan Provincial InfectiousD Liseases Hospital,Kunming,Yunnan 650301,China;不详)

机构地区：[1]云南省传染病医院检验科,云南昆明650301 [2]昆明医科大学公共卫生学院 [3]大理大学公共卫生学院

出　　处：《中国国境卫生检疫杂志》2023年第1期96-100,共5页Chinese Journal of Frontier Health and Quarantine

基　　金：国家自然科学基金项目(81960605);云南省教育厅项目(2019J1305);云南省科技厅-昆明医科大学应用基础研究联合专项面上项目(202101AY070001-223,202201AY070001-208);云南省科技厅重大专项(202102AA310005);昆明医科大学艾滋病共感染传染性疾病诊疗科技创新团队(CXTD202111);云南省高层次卫生技术人才培养经费资助项目(H-2018050)。

摘　　要：目的 探讨云南省昆明地区HIV感染者、HCV感染者和HIV/HCV共感染者的免疫、生化指标之间的差异,以及与HCV病毒载量(HCV-RNA)之间的关系,为HIV/HCV共感染的临床诊断、治疗提供依据。方法 收集云南省传染病医院2018年入院确诊的HIV感染者、HCV感染者、HIV/HCV共感染者以及有精神疾病患者(对照)的血清样本,检测丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、谷氨酰转肽酶(GGT)、总胆红素(TBIL)、总胆汁酸(TBA)等生化指标;采用流式细胞术对CD4+T淋巴细胞和CD8+T淋巴细胞进行计数,用PCR-荧光探针法检测HCV-RNA。结果 共收集HIV感染者、HCV感染者和HIV/HCV共感染者310例,其中HCV感染组27例,HIV感染组51例,HIV/HCV共感染组128例。HIV感染组(211.17±169.25)和HIV/HCV共感染组(228.76±154.25)CD4+T淋巴细胞计数明显低于HCV感染组(444.50±280.68)(F=18.02,P<0.01),而它们之间的CD8+T淋巴细胞计数差异无统计学意义(F=0.229,P=0.80)。HCV感染组ALT 35.50 (17.25,78.75)、AST 44.00 (20.25,122.50)、GGT 50.50(25.50,111.00)、TBIL19.55(8.35,79.8)、TBA 8.25(5.50,73.45)和HIV/HCV共感染组ALT 38.00 (25.25,63.75)、AST 49.50 (31.25,81.75)、GGT 110.00 (56.00,229.75)、TBIL13.00 (9.05,22.22)和TBA 9.10 (4.60,21.80)均高于对照组,但HIV/HCV共感染组的TBIL 13.00(9.05,22.22)、ALT 38.00(25.25,63.75)、AST 31.25(81.75)和TBA 9.10(4.60,21.80)值低于HCV感染者组,而HIV/HCV共感染组的GGT 9.10(4.60,21.80)明显高于HCV感染组(P<0.05)。HIV/HCV共感染组的HCV-RNA值(9.10×10^(7)±1.69×10^(6))明显高于HCV感染组(1.23×10^(7)±3.04×10^(6)),差异有统计学意义(t=2.26,P=0.03),并随着HCV-RNA值的升高,ALT与AST也呈上升趋势(P<0.05)。结论 人体感染HCV后ALT、AST、TBA、TBIL及GGT等肝功能指标出现异常,合并感染HIV后进一步加重肝脏损伤,同时HCV病毒载量也明显升高。Objective To investigate the differences of biochemical and immune indexes among HIV-infected,HCV-infected and HIV/HCV co-infected patients in Kumming,Yunnan,explore the relationship between HCV viral load(HCV-RNA) and biochemical and immune indexes,to provide basis for clinical diagnosis and treatment of HIV/HCV co-infection.Methods The serum samples of HIV-infection,HCV-infection,HIV/HCV co-infection patients and mentally ill patients of Yunnan Infectious Diseases Hospital in 2018 were collected,alanine aminotransferase (ALT),aspartate aminotransferase (AST),glutamyl peptide transaminase (GGT),total bilirubin (TBIL),total bile acids (TBA) were detected,CD4+ and CD8+ T lymphocytes were counted by flow cytometry.Viral load (HCV-RNA) quantification was performed by Real-time PCR.Results A total of 310 cases were enrolled,including 27 cases of HCV infection,51 of HIV infection,128 of HIV/HCV co-infection,and 310 serum samples were collected.The counts of CD4+ T lymphocytes in HIV infection group (211.17±169.25) and HIV/HCV co-infection group (228.76±154.25) were significantly lower than those in HCV infection group (444.50±280.68)(F=18.02,P<0.01),while there was no statistical difference in CD8+ T lymphocyte counts between them (F=0.229,P=0.80).ALT 35.50(17.25,78.75),AST 44.00(20.25,122.50),GGT 50.50 (25.50,111.00),TBIL 19.55 (8.35,79.8),TBA 8.25 (5.50,73.45) in HCV infection group and ALT 38.00(25.25,63.75),AST49.50 (31.25,81.75),GGT110.00 (56.00,229.75),TBIL13.00 (9.05,22.22),TBA9.10 (4.60,21.80) in HIV/HCV co-infection group were higher than control group (P<0.05).However,the values of TBIL 13.00(9.05,22.22),ALT38.00 (25.25,63.75),AST 31.25 (81.75),TBA9.10 (4.60,21.80) in HIV/HCV co-infection group were lower than HCV infection group (P<0.05).The GGT 9.10(4.60,21.80) of HIV/HCV co-infection group was significantly higher than that of HCV infection group (P<0.05).The HCV-RNA value of HIV/HCV co-infection group (9.10×10^(7)±1.69×10^(6))was significantly higher than that of HCV infection group (1.23×10^(7)±

关 键 词：丙型肝炎病毒 人类免疫缺陷病毒 共感染 病毒载量 生化指标 

分 类 号：R373.21[医药卫生—病原生物学]