昆明地区丙型肝炎病毒感染者与HIV合并丙型肝炎病毒感染者肝损伤研究简

目的探讨单纯丙型肝炎病毒（HCV）感染和人类免疫缺陷病毒（HIV）合并HCV感染者肝损伤的差异。方法对抗病毒治疗前的HIV合并HCV感染患者、HIV感染者和单纯慢性HCV感染者进行病毒载量、肝功能包括天冬氨酸氨基转移酶（AST）、丙氨酸氨基转移酶（ALT）和总胆红素（TBIL）水平]和CD4＋T淋巴细胞计数的检测，对实验数据进行统计学分析。结果纳入研究的325例HIV合并HCV感染患者、97例单纯慢性丙型肝炎患者和582例单纯HIV感染者均存在肝功能异常，以单纯慢性HCV感染患者肝功能异常最为明显；合并感染者按HCV病毒载量分为HCVRNA〉1×10^3 IU／ml、〉1×10^4 IU／ml和〉1×10^5 IU／ml等三组，发现组间肝损伤的差异无统计学意义；合并感染患者按CD4＋T淋巴细胞数水平分为〉200个／ul和〈200个／ul两个组，组间肝损伤的差异无统计学意义。结论抗病毒治疗前单纯慢性HCV感染者的肝损伤程度较HIV／HCV合并感染者严重，合并感染者其HCV病毒载量和CD4＋T淋巴细胞水平差异对肝损伤程度无影响。

Comparison of liver damage between patients with simply HCV infection and HIV/HCV co-infection

Objective To compare the status of liver damage in patients with simply chronic hepatitis C infection and HCV/HIV co-infection and study factors that may influence the progress of the disease prior to highly active antiretroviral therapy （HAART） in Kunming of China. Methods Blood samples were collected prior to the antiretrovirai therapy from 97 patients with simply chronic HCV infection, 325 with HIV / HCV co-infection and 582 cases with only HIV infection. Serum levels of alanine transaminase （ALT）, aspartate transaminase （AST） and total bilirubin （TBIL）, HCV viral load and the counts of CD4＋ T-lymphocytes were measured. According to the HCV load, HCV/HIV co-infected patients were divided into three groups： HCV RNA 1×10^3 IU/ml, 〉1×10^4 IU/ml and 〉1×10^5 IU/ml; and based on the CD4＋ T cell count, the HCV/ HIV co-infected patients were grouped into CD4＋ T〉200/ul and 〈200/ul groups. Statistical analysis was done by one-way ANOVA. Results All patients demonstrated abnormal levels of ALT, AST and TBIL, and the liver damage in patients with simply chronic HCV infection were the worst among all three groups. There were no significant differences （P〉0. 05） in liver damage by HCV loads and CD4＋ T cell counts. Conclusions Patients with simply chronic HCV infection showed more severe liver damage than patients with HIV/HCV coinfection in Kunming of China. HCV load and CD4＋ T-lymphocytes counts in patients with HIV/HCV co-in fection didn＇t show significant effects on liver damage.