丙型肝炎病毒/乙型肝炎病毒重叠感染对维持性血液透析患者HBV DNA水平及肝功能的影响

目的探讨HCV重叠感染对HBV感染的维持性血液透析（MHD）患者HBV DNA水平的影响。方法选取HBV感染血清标志物阳性的MHD患者178名,将其分为HBV合并HCV感染组（HBV＋HCV＋组,n=86）和单纯HBV感染组（HBV＋HCV-组,n=92）,同时检测两组HBV DNA水平及主要血生化指标。结果两组ALT、AST水平无明显差异（P〉0.05）,HBV＋HCV＋组HBVDNA水平较HBV＋HCV-组明显降低（0.42±0.10）log scale/ml vs（1.25±0.28）log scale/ml,P〈0.01]。多元Logistic回归分析显示HCV感染与低HBV DNA水平独立相关（OR=0.316,95%CI：0.124～0.703,P〈0.01）。结论在HBV感染的MHD患者中,合并HCV感染能显著降低患者的HBV DNA水平,而不引起明显的肝功能损害加重。

The impact of HBV/HCV coinfection on HBV DNA levels and the severity of liver diseases in HBV-infected patients undergoing hemodialysis

Objective To investigate the impact of hepatitis B virus（HBV）/hepatitis C virus（HCV） coinfection on HBV DNA levels and the severity of liver diseases in HBV-infected patients undergoing hemodialysis.Methods A total of 178 hemodialysis patients showing positivity for HBV infection were enrolled for study and divided into two groups according to co-or monoinfection status.Eighty-six patients tested positive for both HBV and HCV（HBV＋/HCV＋ group）,and 92 patients tested positive for HBV and negative for HCV（HBV＋/HCV-group）.HBV DNA levels and blood biochemical parameters were measured.The significance of inter-group differences was assessed by t-test（normally distributed data） or Mann-Whitney U test（non-normally distributed data）.Multivariate logistic stepwise regression was use to evaluate the association of parameters with HCV infection.Results The two groups showed similar levels of serum aminotransferase（P0.05）.In contrast,the HBV＋/HCV＋ patients showed significantly lower levels of serum HBV DNA than the HBV＋/HCV-patients （0.42±0.10） vs.（1.25±0.28）log scale/ml,P0.01].HCV infection was found to be independently associated with lower HBV DNA levels（OR=0.316,95% CI：0.236-0.865,P0.01）.Conclusion In hemodialysis patients,HBV/HCV coinfection is associated with lower HBV DNA levels but not more severe liver diseases.