抗反转录病毒治疗作用下丙型肝炎病毒现症感染病例特征  

Characteristics of hepatitis C virus current infection under antiretroviral therapy

作　　者：薛秀娟[1] 李绍岗 刘洋[1] 刘春华[1] 张向兵[1] 袁源[1] 闫江舟[1] 刘家琪 耿杰 任亭亭 段立凡 李宁[1] 张国龙 XUE Xiujuan;LI Shaogang;LIU Yang;LIU Chunhua;ZHANG Xiangbing;YUAN Yuan;YAN Jiangzhou;LIU Jiaqi;GENG Jie;REN Tingting;DUAN Lifan;LI Ning;ZHANG Guolong(Henan Provincial Center for Disease Control and Prevention,Zhengzhou 450016,China;Jiaozuo Center for Disease Control and Prevention)

机构地区：[1]河南省疾病预防控制中心性病艾滋病防治研究所,河南郑州450016 [2]焦作市疾病预防控制中心

出　　处：《现代疾病预防控制》2024年第12期889-893,共5页MODERN DISEASE CONTROL AND PREVENTION

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20220162)。

摘　　要：目的分析抗反转录病毒治疗(ART)作用下丙型肝炎病毒(HCV)现症感染病例的免疫重建和病毒复制特征。方法2023年对河南省45例HIV/HCV共感染的HCV现症感染者和36例单纯HIV-1感染者开展回顾性研究,检测HCV RNA、CD4、病毒载量(VL)、HIV-1 DNA等指标,综合既往检测结果,分析ART作用下HCV现症感染者的免疫学和病毒学指标。结果HIV/HCV共感染的HCV现症感染者与单纯HIV-1感染者接受一线方案的比例分别为82.22%(37/45)、94.44%(34/36)。HCV RNA和基因型检测显示,HCV现症感染者的HCV RNA(Log10)为5.90(5.29,6.68),HCV基因型主要以1b(68.89%)和2a(22.22%)为主。2020—2023年4次CD4和3次VL结果分析,HCV现症感染者和单纯HIV-1感染者的CD4随访基线值分别为472.00(358.00,729.00)和597.50(420.30,737.30)个/μL。ART作用下两组的HIV-1完全病毒抑制比例分别为95.56%~97.78%和86.11%~91.67%。HIV-1 DNA分析比较发现,HCV现症感染组、单纯HIV-1感染组的HIV-1 DNA分别为234.57(103.61,427.18)和99.46(30.44,351.48)copies/106cells,差异有统计学意义(Z=2.26,P<0.05)。结论调查期间未明显发现HCV现症感染对HIV-1抗反转录病毒治疗的不良影响,但高水平的HIV-1病毒储存库需引起关注。Objective To analyze the immune reconstitution and viral replication characteristics of hepatitis C virus(HCV)current infection under HIV antiretroviral therapy(ART).Methods A retrospective study was carried out in 45 HCV current infection patients with co-infection of HIV/HCV and 36 patients with HIV-1 mono-infection in Henan Province.HCV RNA,CD4,VL and HIV-1 DNA were detected;the immunological and virological indicators of HCV current infection under ART were analyzed in 2023.Results The proportions of HIV/HCV patients with HCV current infection and patients with HIV-1mono-infection receiving the first line regimen were 82.22%(37/45)and 94.44%(34/36),respectively.HCV RNA and genotype detection showed that HCV RNA(Log10)in HCV current infection patients was 5.90(5.29,6.68),and HCV genotypes were mainly 1b(68.89%)and 2a(22.22%).The analysis of four-times CD4 testing results and three-times VL testing results from2020 to 2023 showed that the baseline CD4 of HCV current infection patients and HIV-1 patients were 472.00(358.00,729.00)and597.50(420.30,737.30)perμL,respectively.The proportions of complete HIV-1 viral suppression in the two groups under ART were between 95.56%-97.78%and between 86.11%-91.67%,respectively.HIV-1 DNA analysis showed that in HCV current infection patients and HIV-1 patients,HIV-1 DNA were 234.57(103.61,427.18)and 99.46(30.44,351.48)copies/106cells,respectively.There was a significant difference between the two groups(Z=2.26,P<0.05).Conclusions The adverse effect of HCV current infection on antiretroviral therapy is not shown during the investigation,but the high HIV-1 viral reservoir should be concerned.

关 键 词：HCV现症感染者 单纯HIV-1感染者 抗反转录病毒治疗 HCV基因型 

分 类 号：R512.6[医药卫生—内科学]