HIV合并肝炎病毒感染肝功能相关指标及免疫功能变化分析  

An Analysis of Liver Function Related Indicators and Immune FunctionChanges in HIV Combined with Hepatitis Virus Infection

作　　者：陈慧[1] 徐俊驰[1] 朱月萍[2] 王银玲 宋华峰[1] 胥萍[1] CHEN Hui;XU Junchi;ZHU Yueping;WANG Yinling;SONG Huafeng;XU Ping(Department of Clinical Laboratory,The Fifth People’s Hospital of Suzhou,Suzhou 215000,China;Infectious Department,The Fifth People’s Hospital of Suzhou,Suzhou 215000,China)

机构地区：[1]苏州市第五人民医院检验中心,江苏苏州215000 [2]苏州市第五人民医院感染科,江苏苏州215000

出　　处：《标记免疫分析与临床》2023年第8期1310-1315,共6页Labeled Immunoassays and Clinical Medicine

基　　金：江苏省卫健委面上项目(编号:M2021066);苏州市科技局项目(编号:SYS2020190,SZS2020311)。

摘　　要：目的探讨HIV感染者合并肝炎病毒感染后,肝功能及淋巴细胞亚群的变化,为单纯性HIV感染和HIV合并肝炎病毒感染的研究提供相关依据。方法选取苏州市第五人民医院HIV感染者460例,用实时荧光定量PCR的方法检测乙肝DNA载量(HBV-DNA)和丙肝病毒RNA载量(HCV-RNA),以HBV-DNA含量大于500IU/mL为乙肝病毒感染,以HCV-RNA含量大于500IU/mL为丙肝病毒感染,将460例HIV感染者分为HIV单纯感染、HIV合并HBV、HIV合并HCV 3组。全自动生化分析仪检测3组HIV感染中血清丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)和γ-谷氨酰基转移酶(GGT-γ);应用流式细胞仪检测外周血淋巴细胞及亚群分布;同时用五分类血细胞分析仪检测外周血淋巴细胞的数量,采用双平台检测的方法得出CD4^(+)T淋巴细胞的绝对值。对数据进行性别、年龄、病毒载量、肝功能、淋巴细胞及亚群等多因素分析。结果(1)460例HIV感染者,单纯HIV感染为208例(45.2%),HIV合并HBV感染为173例(37.6%),HIV合并HCV感染为79例(17.2%),3组分布与性别、年龄构成差异无统计学意义(P>0.05)。(2)3组患者中HIV合并HBV组ALT、AST均高于其余两组,且差异存在统计学意义(P<0.05)。(3)CD3^(+)T细胞的比例和绝对计数HIV合并HBV组显著低于其余两组(P<0.05);而CD4^(+)T的比例则在HIV合并HBV组中最高,显著高于其余两组(P<0.05);CD8^(+)T的比例与CD4^(+)T相反,在HIV合并HBV组中最低(P<0.05)。(4)对CD4^(+)T细胞绝对计数值划分区间,可见单纯HIV感染的患者69%在<200个/μL的区间内,而其余两组均以200~400个/μL区间为主。结论HIV感染者合并肝炎病毒(HBV或HCV)感染后发生肝功能损害更为严重,同时合并感染后可能更高水平的增加淋巴细胞的激活,淋巴细胞亚群的变化更为复杂,导致机体免疫功能的多样化。Objective To investigate changes in liver function and lymphocyte subsets in HIV infected individuals with hepatitis virus infection,so as to identify the related basis for research on HIV infection and HIV combined hepatitis virus infection.Methods 460 cases of HIV patients from Suzhou Fifth People’s Hospital were selected for the study.Hepatitis B DNA load(HBV-DNA)and hepatitis C virus RNA load(HCV-RNA)were detected by real-time fluorescent quantitative PCR method.According to the PCR results,460 HIV patients were divided into three groups:HIV infection(HIV),HIV combined with HBV(HIV/HBV),and HIV combined with HCV(HIV/HCV).Serum alanine transaminase(ALT),aspartate transaminase(AST)and glutamyltransferase(GGT-r)in three groups of HIV infection were detected by automatic biochemical analyzer.The distribution of lymphocytes and subsets in peripheral blood was detected by flow cytometry.The number of peripheral blood lymphocytes was detected by the five classification blood cell analyzer,and the absolute value of CD4^(+)T lymphocytes was obtained by the dual platform detection method.Multiple factor analysis was conducted on the dataset,including gender,age,viral load,liver function,lymphocytes,and subpopulations.Results(1)Among 460 HIV infected individuals,208 were infected with HIV alone(45.2%),173 were infected with HIV combined with HBV(37.6%),and 79 were infected with HIV combined with HCV(17.2%).The distribution of the three groups showed no difference in gender and age composition(P>0.05).(2)Among the three groups of patients,ALT and AST levels in the HIV combined with HBV group were significantly higher than those in the other two groups(P<0.05).(3)The proportion and absolute count of CD3^(+)T cells in the HIV combined with HBV group were significantly lower than those in the other two groups(P<0.05).The proportion of CD4^(+)T was the highest in the HIV combined with HBV group,significantly higher than the other two groups(P<0.05).The proportion of CD8^(+)T was opposite to CD4^(+)T,and was the lowest in t

关 键 词：HIV感染 HIV合并HBV HIV合并HCV 

分 类 号：R512.91[医药卫生—内科学]