HCV RNA水平对HCV/HIV合并感染自然进程的影响

目的 探讨HCV RNA PCR水平对丙型肝炎病毒（HCV）/人类免疫缺陷病毒（HIV）合并感染自然进程的影响.方法 采用实时荧光定量PCR方法检测HCV RNA,比较初次就诊高效反转录病毒治疗（HAART）前的HCV/HIV合并感染（HCV/HIV组）、HCV单纯感染（HCV组）、HIV单纯感染（HIV组）患者的HCV RNA、HIV RNA、CD4＋T淋巴细胞计数、天冬氨酸转氨酶（AST）、总胆红素（TBIL）、透明质酸酶（HA）、层粘连蛋白（LN）、甘胆酸（CG）、Ⅲ型胶原（PCⅢ）、Ⅳ型胶原（CⅣ）、年龄等指标.结果 HCV/HIV组与HCV组和HIV组CD4＋T淋巴细胞计数分别为139.75±91.586、647.16±363.379、288.0±219.6个/微升（P＜0.01）.与HCV组患者的发病年龄分别为37±15和52±13岁（P＜0.01）.HCV RNA分别为6.0417±0.93524和5.2553±1.62773log/ml（P＜0.05）;CⅣ分别为105.30±24.630和95.41±52.889ng/ml（P＜0.05）;CG分别为1444.98±1721.597、139.00±165.640μg/ml （P＜ 0.01）;PCⅢ分别为285.52±244.558、159.82±86.928ng/ml（P＜ 0.01）;ALT分别为104.42±107.90、46.22±32.589U/L（P ＜0.01）.与HIV组HIV RNA分别为4.8±0.9和4.1±1.0log/ml（P ＜0.01）.结论 HCV/HIV合并感染可以加重和加快HCV、HIV疾病的自然进程.高水平的HCV RNA是HCV/HIV合并感染患者的HCV、HIV疾病自然进程的危险因素之一.

Impact of The HCV RNA Levels of HCV/HIV Co-infected Patients on Natural process

Objective To investigate the impact of the HCV RNA levels of HCV/HIV co-infected patients on natural process of HCV and HIV disease.Methods We compared the levels of HCV RNA,HIV RNA,CD4 ＋ T lymphocyte count and alanine aminotransferase （ALT）,total bilirubin （TBIL）,hyaluronidase （HA）,laminin （LN）,cholyglycine （CG）,Ⅲ collagen （PC Ⅲ）,Ⅳ collagen （C Ⅳ） and age of HIV/HCV co-infected patients group with HCV infected group and HIV infected group.Results The CD4 ＋ T lymphocyte counts were 139.75 ± 91.586,647.16 ± 363.379,288.0 ± 219.6/μl in HCV/HIV group and HCV group and HIV group respectively （P ＜0.01）,compared with HCV group and HIV group （P ＜ 0.01）.Compared with HCV group,the levels of HCV RNA was 6.0417 ± 0.93524 and 5.2553 ± 1.62773log/ml（P ＜ 0.05）,the levels of CIV,CG,PC Ⅲ,ALT were 105.30 ± 24.630 and 95.41 ± 52.889ng/ml（P ＜0.05） ;1444.98 ± 1721.597,139.00 ± 165.640μ g/ml（P ＜0.01） ;PC Ⅲ285.52 ± 244.558、159.82 ± 86.928ng/ml（P ＜ 0.01） ;104.42 ± 107.9、46.22 ± 32.589U/L P ＜ 0.01） and the age were （37 ± 15） and （52 ± 13） （P ＜ 0.01）.Compared with HIV group,the level of HIV RNA were 4.8 ± 0.9log/ml and 4.1 ± 1.0log/ml（P ＜ 0.01）.Conclution HCV/HIV coinfection can aggravate and accelerate natural course of HCV and HIV disease.High level of HCV RNA of HCV/HIV coinfected patients is a risk factor for worsening the natural course of HCV and HIV diseases.