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依非韦仑为主的方案治疗人类免疫缺陷病毒/丙型肝炎病毒感染患者的安全性和有效性
引用本文:孙洪清,黄琴,王江蓉,张仁芳,张学祥,董婕,戴振声,蔡卫平,卢洪洲. 依非韦仑为主的方案治疗人类免疫缺陷病毒/丙型肝炎病毒感染患者的安全性和有效性[J]. 中华传染病杂志, 2011, 29(2). DOI: 10.3760/cma.j.issn.1000-6680.2011.02.009
作者姓名:孙洪清  黄琴  王江蓉  张仁芳  张学祥  董婕  戴振声  蔡卫平  卢洪洲
作者单位:1. 上海市公共卫生临床中心感染科,201508
2. 广州市第八人民医院感染科
基金项目:卫生部艾滋病防治研究项目,国家科技重大专项项目
摘    要:目的 评价以依非韦仑为主的方案治疗HIV/HCV合并感染患者的安全性和有效性.方法 以依非韦仑为主的方案治疗53例HIV/HCV合并感染患者7年,观察CD4+T淋巴细胞计数、HIV RNA、肝功能、肝纤维化指标、血脂、血糖、血尿酸、血常规的变化.治疗前、后均数的比较采用t检验.结果 53例患者治疗前、后HIV RNA分别为(4.56±0.88)lg拷贝/mL和(1.70±1.10)lg拷贝/mL(t=14.781,P<0.01);CD4+T淋巴细胞分别为(188.37±151.14)×106/L和(445.18±314.25)×106/L(t=5.362,P<0.01);ALT分别为(36.6±16.3)和(57.2±9.9)U/L(t=7.864,P<0.01);甘胆酸(CG)分别为(444.22±476.74)和(556.88±733.05)mg/L(t=0.938,P<0.05);ⅣC分别为(45.13±8.25)和(47.88±4.51)ng/mL(t=2.129,P<0.05);三酰甘油分别为(1.57±0.65)和(2.51±1.29)mmol/L(t=4.737,P<0.01);血尿酸分别为(298.5±48.2)和(495.1±89.4)mmo1/L(t=14.092,P<0.01).结论 以依非韦仑为主的方案治疗HIV/HCV合并感染患者是有效的,但可引起肝脏功能损害和代谢异常.
Abstract:
Objective To evaluate the efficacy and safety of efavirenz-based therapy in patients with human immunodeficiency virus (HIV)/hepatitis C virus (HCV) co-infection. Methods Fiftythree HIV/HCV co-infected patients received efavirenz-based therapy were followed up for 7 years.The changes of CD4+ T lymphocyte count, HIV virus load, hepatic function, hepatic fibrosis index,blood lipid, blood glucose, blood uric acid and blood routine were observed. The comparison of means before and after treatment was performed by t-test. Results The HIV RNA levels at baseline and endpoint were (4. 56±0. 88) lg copy/mL and (1.70±1.10) lg copy/mL, respectively (t=14. 781, P<0.01). The peripheral blood CD4+ T lymphocyte counts were ( 188.37±151.14)×106/L and (445.18±314.25)×106/L, respectively (t=5.362, P<0.01).The alanine aminotransferase (ALT) levels were (36.6±16.3) U/L and (57.2±9.9) U/L, respectively (t=7.864, P<0. 01).The glycocholic acid levels were (444.22±476.74) mg/L and (556.88±733.05) mg/L, respectively (t=0.938, P<0.05). The Ⅳ-collagen(Ⅳ-C) levels were (45.13±8.25) ng/mL and (47.88±4.51) ng/mL, respectively (t= 2.129, P<0.05). The riacylglycerol levels were (1.57±0.65)mmol/L and (2.51±1.29) mmol/L, respectively (t=4.737, P<0.01). The blood uric acid levels were (298.5±48.2) mmol/L and (495.1±89.4) mmol/L, respectively (t= 14.092, P<0.01).Conclusions The efavirenz-based therapy is efficacious in HIV/HCV co-infected patients, but it could cause liver injury and metabolic disorder.

关 键 词:逆转录酶抑制剂  HIV感染  肝炎,丙型  抗逆转录病毒治疗,高效

Efficacy and safety of efavirenz-based regimens in human immunodeficiency virus/hepatitis C virus co-infected patients
SUN Hong-qing,HUANG Qin,WANG Jiang-rong,ZHANG Ren-fang,ZHANG Xue-xiang,DONG jie,DAI Zheng-sheng,CAI Wei-ping,LU Hong-zhou. Efficacy and safety of efavirenz-based regimens in human immunodeficiency virus/hepatitis C virus co-infected patients[J]. Chinese Journal of Infectious Diseases, 2011, 29(2). DOI: 10.3760/cma.j.issn.1000-6680.2011.02.009
Authors:SUN Hong-qing  HUANG Qin  WANG Jiang-rong  ZHANG Ren-fang  ZHANG Xue-xiang  DONG jie  DAI Zheng-sheng  CAI Wei-ping  LU Hong-zhou
Abstract:Objective To evaluate the efficacy and safety of efavirenz-based therapy in patients with human immunodeficiency virus (HIV)/hepatitis C virus (HCV) co-infection. Methods Fiftythree HIV/HCV co-infected patients received efavirenz-based therapy were followed up for 7 years.The changes of CD4+ T lymphocyte count, HIV virus load, hepatic function, hepatic fibrosis index,blood lipid, blood glucose, blood uric acid and blood routine were observed. The comparison of means before and after treatment was performed by t-test. Results The HIV RNA levels at baseline and endpoint were (4. 56±0. 88) lg copy/mL and (1.70±1.10) lg copy/mL, respectively (t=14. 781, P<0.01). The peripheral blood CD4+ T lymphocyte counts were ( 188.37±151.14)×106/L and (445.18±314.25)×106/L, respectively (t=5.362, P<0.01).The alanine aminotransferase (ALT) levels were (36.6±16.3) U/L and (57.2±9.9) U/L, respectively (t=7.864, P<0. 01).The glycocholic acid levels were (444.22±476.74) mg/L and (556.88±733.05) mg/L, respectively (t=0.938, P<0.05). The Ⅳ-collagen(Ⅳ-C) levels were (45.13±8.25) ng/mL and (47.88±4.51) ng/mL, respectively (t= 2.129, P<0.05). The riacylglycerol levels were (1.57±0.65)mmol/L and (2.51±1.29) mmol/L, respectively (t=4.737, P<0.01). The blood uric acid levels were (298.5±48.2) mmol/L and (495.1±89.4) mmol/L, respectively (t= 14.092, P<0.01).Conclusions The efavirenz-based therapy is efficacious in HIV/HCV co-infected patients, but it could cause liver injury and metabolic disorder.
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