初治HIV感染者病毒载量与血清肝损伤标志物的相关性研究  

Correlations between viral load and serum liver injury markers in treatment-naïve HIV infectors

作　　者：余梅 黄志忠[2] 覃江龙 韦贞伟[2] 覃亚勤[2] YU Mei;HUANG Zhizhong;QIN Jianglong;WEI Zhenwei;QIN Yaqin(Department of Internal Medicine,the Fourth People's Hospital of Nanning,Nanning 530023,Guangxi,China;Department of Hepatology,the Fourth People's Hospital of Nanning,Nanning 530023,Guangxi,China;Department of Infectious Disease,the Fourth People's Hospital of Nanning,Nanning 530023,Guangxi,China)

机构地区：[1]广西南宁市第四人民医院内科,南宁市530023 [2]广西南宁市第四人民医院肝病科,南宁市530023 [3]广西南宁市第四人民医院感染科,南宁市530023

出　　处：《内科》2024年第4期387-391,共5页Internal Medicine

基　　金：广西壮族自治区卫生健康委员会自筹课题(Z20211129);广西南宁市第四人民医院院内课题(NNSY2021003)。

摘　　要：目的探讨初治人类免疫缺陷病毒(HIV)感染者病毒载量与血清肝损伤标志物的相关性。方法回顾性分析南宁市第四人民医院402例初治HIV感染者的临床资料,并根据病毒载量将患者分为A组(<1×10^(4)拷贝/mL)、B组(1×10^(4)~<1×10^(5)拷贝/mL)、C组(1×10^(5)~<1×10^(6)拷贝/mL)、D组(≥1×10^(6)拷贝/mL)。分析并比较各组患者的临床特征和肝酶异常情况,采用Spearman秩相关分析探究HIV病毒载量与肝损伤标志物的相关性。结果402例初治HIV感染者,肝酶异常总发生率为23%(92/402),其中有15%(60/402)的患者丙氨酸转氨酶(ALT)升高,7%(29/402)的患者天冬氨酸转氨酶(AST)升高,13%(51/402)的患者γ-谷氨酰转移酶(GGT)升高,3%(13/402)的患者碱性磷酸酶(ALP)升高。不同病毒载量HIV感染者的年龄、性别、ALT、AST、GGT、ALP、总胆红素、直接胆红素、CD4+T淋巴细胞计数、HIV RNA、肝酶异常率、ALT升高率、AST升高率、GGT升高率、ALP升高率方面差异均有统计学意义(均P<0.05)。HIV病毒载量与ALT、AST、GGT、ALP水平均呈正相关(r_(s)=0.152,P=0.002;r_(s)=0.312,P<0.001;r_(s)=0.277,P<0.001;r_(s)=0.143,P=0.004)。结论HIV感染者HIV病毒载量与血清肝损伤标志物存在相关性,临床上需要加强对患者肝功能的监测及处理。Objective To investigate the correlations between viral load and serum liver injury markers in treatment-naïve human immunodeficiency virus(HIV)infectors.Methods The clinical data of 402 treatment-naïve HIV infectors in the Fourth People's Hospital of Nanning were retrospectively analyzed,and they were divided into group A(<1×10^(4)copies/mL),group B(1×10^(4)-<1×10^(5)copies/mL),group C(1×10^(5)-<1×10^(6)copies/mL),and group D(≥1×10^(6)copies/mL)according to their viral loads.The clinical characteristics and liver enzyme abnormalities of each group were analyzed and compared,and the Spearman rank correlation analysis was used to explore the correlations between HIV viral load and liver injury markers.Results Among the 402 treatment-naïve HIV infectors,the overall incidence of liver enzyme abnormalities was 23%(92/402),of which 15%(60/402)had an elevation in alanine transaminase(ALT),7%(29/402)in aspartate transaminase(AST),13%(51/402)inγ-glutamyl transferase(GGT),and 3%(13/402)in alkaline phosphatase(ALP).There were statistically significant differences in age,sex,ALT,AST,GGT,ALP,total bilirubin,direct bilirubin,CD4+T lymphocyte count,HIV RNA,incidence of liver enzeme abnormalities,ALT elevation rate,AST elevation rate,GGT elevation rate,and ALP elevation rate among HIV infectors with different viral loads(all P<0.05).HIV viral load was positively correlated with the levels of ALT,AST,GGT,and ALP(r_(s)=0.152,P=0.002;r_(s)=0.312,P<0.001;r_(s)=0.277,P<0.001;r_(s)=0.143,P=0.004).Conclusion HIV viral load correlates with serum liver injury markers in HIV infectors,among whom it is necessary to strengthen the monitoring and management of liver function.

关 键 词：人类免疫缺陷病毒 获得性免疫缺陷综合征 病毒载量 肝损伤 

分 类 号：R511[医药卫生—内科学]