HIV感染者混合感染HBV、HCV的调查研究

目的分析常德市近13年来人类免疫缺陷病毒(HIV)合并感染乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)状况及其预后,为揭示HIV、HBV、HCV混合感染规律,为HIV的预防、治疗及判断预后提供科学依据。方法按照国家标准检验方法对常德市120例HIV感染者进行CD4 、CD8 T淋巴细胞计数,丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)检测,HBV五项、抗HCV检测,对检测结果做系统的比较和分析。结果120例HIV感染者中,以青壮年为主要人群,以性传播为主要感染方式;混合HCV、HBV感染者有71例,占所有HIV感染者的59.17%。混合感染中,男性明显多于女性(P<0.05),血液传播和静脉吸毒为主要的感染方式,且HIV/HCV,HIV/HBV/HCV混合感染的ALT、AST异常比例明显高于HIV单独感染(P<0.05),HIV/HBV、HIV/HCV、HIV/HBV/HCV三种感染模式的CD4 T淋巴细胞计数明显低于HIV单一感染(P<0.05)。结论HIV感染者混合感染HBV、HCV现状日趋严重,特别在经血液传播、静脉吸毒传播的男性HIV感染人群中更加明显。HIV与多种肝炎病毒合并感染可能加速肝脏和免疫系统的损害,导致更高的发病率和死亡率,影响HIV感染的进程及高效抗逆转录病毒治疗(HAART)。

Study on Co-infection with HBV and HCV in HIV Carriers

Objective To explore the status and prognosis of HIV and co-infection with HBV and HCV in HIV carriers during the past 15 years in Changde Prefecture,and to provide scientific references for finding the rules of multiple infection and measures to control.Methods CD4 and CD8 cells of 120 HIV carriers were counted,and their levels of ALT and AST as well as 5 serological markers of HBV and HCV were detected according to the national standardized methods.And the data were systematically compared and analyzed.Results The young and adults made up the major proportion of the 120 HIV carriers and sexual contacts were the main spread mode(P<0.01).Seventy-one out of the 120 HIV carriers had co-infection with either HBV or HCV or both.Male HIV carriers had higher percentage of co-infection than that of females(P<0.05),and blood transfusion and IV drug users were the chief infection mode.HIV/HCV and HIV/HBV/HCV had higher abnormal ALT and AST results than that of the single HIV infection(P<0.05).CD4 lymphatic cell count in HIV/HBV,HIV/HCV,HIV/HBV/HCV infection models was significantly lower than that of single HIV infection(P<0.05).Conclusions Co-infection with HBV and/or HCV is increasingly frequent;especially in males who got infected HIV by blood transfusion and IV drug abuse.Co-infection with hepatitis viruses can deteriorate liver and immunity function,which may lead to higher mobility and mortality and affect the prognosis of HIV and the HAART.