云南省昆明地区HIV合并感染不同基因型HCV患者血液检测指标分析  

Analysis of blood testing indicators in HIV patients co-infected with different genotypes of HCV in Kunming area of Yunnan Province

作　　者：刘俊仪 亢丽娟 王诗敏 朱燕涛 张米 张念 谢祺 刘仕芳 杨剑陶 李肖 何全英 王佳丽 LIU Junyi;KANG Lijuan;WANG Shimin;ZHU Yantao;ZHANG Mi;ZHANG Nian;XIE Qi;LIU Shifang;YANG Jiantao;LI Xiao;HE Quanying;WANG Jiali(Yunnan Provincial Hospital of Infectious Diseases,Kunming,Yunnan 650301,China;School of Public Health,Kunming Medical University,Kunming,Yunnan 650224,China;School of Public Health,Dali University,Dali,Yunnan 671003,China;The Hong Kong Polytechnic University,Hong Kong 999077,China)

机构地区：[1]云南省传染病医院,云南昆明650301 [2]昆明医科大学公共卫生学院,云南昆明650224 [3]大理大学公共卫生学院,云南大理671003 [4]香港理工大学,中国香港999077

出　　处：《中国热带医学》2024年第3期252-257,275,共7页China Tropical Medicine

基　　金：国家自然科学基金项目(No.81960605);云南省教育厅项目(No.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(No.202101AY070001-223,202201AY070001-208);云南省科技厅重大专项(No.202102AA310005);昆明医科大学艾滋病合并感染传染性疾病诊疗科技创新团队(No.CXTD202111);云南省高层次卫生技术人才培养经费资助项目(No.H-2018050)。

摘　　要：目的了解云南省人类免疫缺陷病毒(human immunodeficiency virus type,HIV)合并感染丙型肝炎病毒(hep‐atitis C virus,HCV)患者基因型分型及其不同基因型间病毒载量、生化指标和血常规指标的差异,为HIV/HCV合并感染患者的疾病诊治提供实验室依据。方法2022年11月—2023年6月在云南省传染病医院抗病毒门诊收集诊断为HIV/HCV合并感染患者血清标本及基本信息,采用一步法实时荧光定量聚合酶链反应(real-time fluorescence quantification polymerase chain reaction,qRT-PCR)扩增检测HCV病毒载量,并对检测阳性样本进行测序,基于NS5基因序列进行基因分型。分析HIV/HCV合并感染HCV不同基因型和低、高病毒载量患者生化和血常规指标间差异。结果共收集到HIV/HCV合并感染患者126例,其中HCV基因1型20例(15.9%),基因3型91例(72.2%)和基因6型15例(11.9%)。HCV 3种基因型的病毒载量最大值和最小值分别为:1型(1.0×10^(8)、4.8×10^(4) IU/mL)、3型(2.2×10^(8)、2.9×10^(2) IU/mL)和6型(8.1×10^(7)、6.8×10^(4) IU/mL)。HIV合并感染不同基因型HCV以及核苷类逆转录酶抑制剂+整合酶链转移抑制剂、核苷类逆转录酶抑制剂+非核苷类逆转录酶抑制剂、核苷类逆转录酶抑制剂+蛋白酶抑制剂3种HIV治疗方案和治疗时间长短与患者病毒载量的差异均无统计学意义(P>0.05)。总胆红素(total Bilirubin,TBIL)、直接胆红素(direct bilirubin,DBIL)、丙氨酸氨基转移酶(alanine aminotransferase,ALT)、天门冬氨酸氨基转移酶(aspartate aminotransferase,AST)、肌酐(creatinine,CREA)等生化指标和白细胞(white blood cell,WBC)、红细胞(red blood cell,RBC)、血红蛋白(hemoglobin,HGB)、血小板(platelet,PLT)、平均血红蛋白量(mean corpuscular hemoglobin,MCH)、平均血红蛋白浓度(mean corpuscu‐lar hemoglobin concentration,MCHC)等血常规指标在不同HCV基因型和低、高病毒载量间的分析结果显示:HIV合并感染HCV患者的生化指标和Objective To understand the genotyping of human immunodeficiency virus(HIV)co-infected hepatitis C virus(HCV)patients in Yunnan Province,and to analyze the differences in viral load,biochemical indicators,and blood routine indicators among different genotypes,in order to provide a laboratory basis for the diagnosis and clinical treatment of HIV/HCV co-infected patients.Methods From November 2022 to June 2023,the serum samples and basic information of patients diagnosed with HIV/HCV co-infection were collected in the antiviral outpatient clinic of Yunnan Provincial Hospital of Infectious Diseases.The HCV viral load was detected by one-step qRT-PCR amplification,the positive samples were sequenced,and genotyping was determined based on NS5 gene sequence.The differences in biochemical and blood routine indexes between HIV patients co-infected with different HCV genotypes and low/high viral loads were analyzed.Results A total of 126 HIV/HCV co-infected patients were collected,including 20 HCV genotype 1(15.9%),91 HCV genotype 3(72.2%),and 15 HCV genotype 6(11.9%).The maximum and minimum viral load of the three HCV genotypes were as follows:HCV type 1(1.0×10^(8),4.8×10^(4) IU/mL),HCV type 3(2.2×10^(8),2.9×10^(2) IU/mL),and HCV type 6(8.1×10^(7),6.8×10^(4) IU/mL).The results showed that there was no significant difference between HIV co-infection with different genotypes of HCV and three HIV treatment schemes,including nucleoside reverse transcriptase inhibitors+integrase strand transfer inhibitors(NRTIs+INSTIs),nucleoside reverse transcriptase inhibitors+non-nucleoside reverse transcriptase inhibitors(NRTIs+NNRTIs)and nucleoside reverse transcriptase inhibitors+protease inhibitor(NRTIs+PLs),and the viral load of patients(P>0.05).The analysis of biochemical indexes such as total bilirubin(TBIL),direct bilirubin(DBIL),alanine aminotransferase(ALT),aspartate aminotransferase(AST),creatinine(CREA),and blood routine indexes such as white blood cell(WBC),red blood cell(RBC),hemoglobin(HGB),platelet(PLT),mean corpuscul

关 键 词：HIV/HCV合并感染 HCV基因型或基因亚型 病毒载量 生化指标 血常规指标 

分 类 号：R512[医药卫生—内科学]