艾滋病合并乙型肝炎患者病毒载量与细胞免疫功能的相关性

目的 探讨艾滋病合并乙型肝炎患者病毒载量与细胞免疫功能的相关性.方法 对2013年2月至2016年2月聊城市中医医院收治的83例艾滋病患者临床资料进行回顾性分析,按照合并或未合并乙型肝炎将其分为观察组38例及对照组45例,比较两组患者生化指标、血常规、病毒学指标,并对T淋巴细胞亚群进行计数,采用Pearson相关分析,分析病毒载量与细胞免疫功能的相关性.结果 观察组谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBIL)分别为(65.43±23.91)U/L、(72.93±33.87)U/L及(16.38±5.51)μmol/L,高于对照组的(32.72±22.15)U/L、(34.53±18.62)U/L以及(11.80±3.17)μmol/L;观察组白蛋白(ALB)为(38.31±6.40)g/L,低于对照组的(42.91±8.02)g/L;观察组患者血小板计数为(160.74±48.60)×109/L,低于对照组(200.85±58.38)×109/L;观察组患者HIV RNA病毒载量为(6.21±1.10)log10 copie/mL,高于对照组(4.26±0.79)log10 copie/mL;上述差异均有统计学意义(P<0.05).观察组患者CD3+、CD4+及CD8+细胞个数及CD4+/CD8+均低于对照组,差异有统计学意义(P<0.05).HIV RNA载量与HBV DNA载量呈正相关(P<0.05);CD4+T细胞及CD4+/CD8+与HBV DNA载量以及HIV RNA载量呈负相关(P<0.05);CD3+T细胞及CD8+T细胞与HBV DNA载量以及HIV RNA载量无显著相关性(P>0.05).结论 HIV/HBV合并感染时,两种病毒可能具有相互促进作用,加重患者肝损伤及免疫缺陷.

Correlation of viral load and cell immunity function in patients with AIDS and hepatitis B

Objective To explore the correlation of viral load and cell immunity function in the patients with AIDS and hepatitis B. Methods The clinical data of 83 AIDS patients ever treated in our hospitals from Feb 2013 to Feb 2016 were retrospectively analyzed, and according to whether or not in combination with hepatitis B, all patients were divided into the study group (38 cases) and the control group (45 cases). Then the biochemical indexes, blood routine indexes and virological indexes between the two groups were compared. After counting the T lymphocyte subgroups, the correlation of viral load and cell immunity function was analyzed by Pearson method. Results In the study group, the serum levels of alanine transaminase (ALT), aspartate transaminase (AST) and total bilirubin (TBIL) (65. 43 ± 23. 91 U/L, 72. 93 ± 33. 87 U/L, 16. 38 ± 5. 51 μmol/L) were significantly higher than those in the control group (32. 72 ± 22. 15 U/L, 34. 53 ± 18. 62 U/L, 11. 80 ± 3. 17μmol/L;all P<0. 05). The albumin (ALB) level in the study group was significantly lower than that in the con-trol group (38. 31 ±6. 40 g/L vs 42. 91 ±8. 02 g/L;P<0. 05). The platelet (PLT) count in the study group was significantly lower than that in the control group (160. 74 ± 48. 60) × 109/L vs (200. 85 ± 58. 38) × 109/L; P<0. 05]. The HIV RNA viral load in the study group was significantly higher than that in the control group (6. 21 ± 1. 10) log10 copie/mL vs (4. 26 ± 0. 79) log10 copie/mL;P<0. 05] . The T cell counts of CD3 +, CD4 + and CD8 + and ratio of CD4 + /CD8 + in the study group were all lower than those in the control group, with significant differences between them (all P<0. 05). The HIV RNA viral load was positively associated with the HBV DNA viral load, but the T cell count of CD4 + and ratio of CD4 + /CD8 + were negatively associated with the HBV DNA and HIV RNA viral loads. No signifi-cant correlation was found between the T cell counts of CD3 + and CD8 + and the HBV DNA and HIV RNA viral loads. Conclusion When coinfected by HIV and HBV, these patients would suffer from severe liver damage and immunodeficiency because of synergistic effect between the two viruses.