HIV对HCV感染者病程影响的探讨

目的通过比较HIV/HCV共感染与HCV单纯感染患者的肝组织病理学改变,研究HIV对HCV自然病程的影响,了解HIV在共感染者肝脏病理改变中所起的作用。方法选取HCV单纯感染者50例,HIV/HCV共感染者18例,在两组临床及实验室资料无显著性差异的情况下,对两组肝脏组织病理进行比较、分析。结果两组在炎症活动度(G)和纤维化程度(S)上均无明显差异(P>0.05)。但是HIV/HCV共感染组较HCV单纯感染组汇管区淋巴细胞明显减少(P<0.001),小叶内库普弗细胞增生较活跃(P<0.001),有明显统计学意义。而在汇管区胆管损伤和炎细胞浸润程度,小叶内炎症浸润程度及范围,有无纤维化和纤维化程度,有无脂肪变性和脂肪变性的程度及类型等多方面的比较中两组标本均无明显差异(P>0.05)。结论合并HIV感染并未明显改变HCV感染者的疾病进程,在其肝脏病理改变中仅使淋巴细胞明显减少,库普弗细胞增生活跃,对炎症活动度和纤维化程度均无明显影响。

An analysis of the impact of HIV on the of disease course of HCV infected patients

Objective To study the impact on HIV on the HCV natural course of disease and the role of HIV in the change of liver pathology of the co-infected patients by comparing the pathology difference between the HIV/HCV co-infected group and the HCV simple infected group.Methods Fifty HCV simple infected patients and 18 of the HIV/HCV co-infected patients were included.The clinical and laboratory data were not different singnificants.The liver pathology of the two groups were analyze.Results There were no distinct differences(P>0.05)between the two groups of patients in the extent of the inflammation activity(G)and the extent of the fibrosis(S).But it was found that the number of the lymphatic cells in the portal area marked decreases(p<0.001)and the proliforatin of the Kupffer cells in the hepatic lobule more active in the co-infected group(P<0.001),It was statistical significant.However,comparison of the bile duct damage,the infitration extent of the inflammation cells,the extent and scope of the inflammation in the hepatic lobule,the extent of the fibrosis and the extent and types of steatosis were not obviously different(P>0.05).Conclusion HIV co-inflection has no evidence in changing the course of disease of the HCV inflected patients.In liver pathology,it could only be found that the number of the lymphatic cells decreases and the proliferalion of the Kupffer cells becomes active.The extent of the inflammation activity(G)and the Atages of the fibrosis(S)are not obviously influenced.