HIV/HCV重叠感染患者病情进展的相关因素研究

探讨HIV/HCV重叠感染患者病情进展的原因和影响预后的相关因素.选择HIV/HCV重叠感染患者这一特定人群,按照疾病进展分成艾滋病组(AIDS)和HIV感染组(free of AIDS),回顾性分析两组间免疫功能、HIV病毒载量、肝脏功能的差异,探讨可能影响病情进展的相关因素.艾滋病组与HIV感染组比较:艾滋病组患者的细胞免疫功能(CD 4T、CD 8T)均低于HIV感染组,差异非常显著(P＜0.001;P=0.003);HIV病毒载量在艾滋病组明显高于HIV感染组,差异显著(P=0.005);艾滋病组的肝脏功能(ALT、AST)明显高于HIV感染组(P值分别为0.043、0.002);蛋白合成指标(TP、ALB)艾滋病组较HIV感染组低下,差异非常显著(P＜0.001).以Logistic回归分析,CD 4T、感染时间和ALB是预测疾病进展的独立危险因素(P＜0.001).回归方程预测准确率为97.0%.HIV/HCV重叠感染可加快病情进展,ALB与CD 4T细胞数及感染时间是预测艾滋病病程进展的独立危险因素.

Associated factors of disease progression in HIV/HCV co- infection

To discuss the reason of disease progression in HIV/HCV co-infected patients. Retrospective study was designed to analysis the immunological function, HIV-RNA Viralload liver function and prognosis in HIV/HCV co-infected patients. According to the disease progression, the patients are divided into two groups: AIDS group and free of AIDS group. The difference of immunological function, liver function in groups was performed statistics analysis. Immunological function (CD 4T, CD 8T) are lower in AIDS group than in free of AIDS group (P<0.001;P=0.003),HIV-RNA viral load is higher in AIDS group than in free of AIDS group (P=0.005). In the aspect of liver function alanine and aspartate aminotramsferase (ALT,AST) are higher in AIDS group than in free of AIDS group (P=0.043;P=0.002). Total protein(TP) and albumin (ALB) are lower in AIDS group than in free of AIDS group (P<0.001). Logistic analysis predicts that CD 4T, duration of HCV infection and ALB are independent risk factors (P<0.001). Predicted percentage of correct is 97.0%. HIV/HCV co-infection effect each other, increasing the disease progression. Albumin, CD 4T cell and duration of HCV infection are independent risk factors of AIDS progression.