经联合抗反转录病毒治疗的因献血感染人类免疫缺陷病毒者肝病相关死亡分析

目的探讨联合抗反转录病毒治疗（cART）对既往因献血感染人类免疫缺陷病毒（HIV）者肝病相关病死率的影响。 方法收集2003年1月至2015年12月武汉大学中南医院诊治的940例既往因献血感染HIV者的性别、年龄、诊断时间、治疗情况、死亡日期和主要死因等资料，回顾性分析638例行cART死亡患者（cART治疗组）和302例未行cART死亡患者（未治疗组）的肝病相关死亡影响因素。 结果cART治疗组患者总体病死率为33.9%（216/638），显著低于未治疗组（93.4%、282/302），差异有统计学意义（χ² = 291.511、P < 0.001）；但cART治疗组肝病相关病死率为7.8%（50/638），显著高于未治疗组（4.0%、12/302），差异有统计学意义（χ² = 4.966、P = 0.026）。其中，cART治疗组患者丙型肝炎病毒感染相关病死率和死亡比例分别为7.1%（45/638）和20.8%（45/216），均显著高于未治疗组2.6%（8/302）和2.8%（8/282）]，差异有统计学意义（χ² = 7.473、P = 0.006，χ² = 41.655、P < 0.001）。 结论在既往因献血感染HIV人群中，cART可降低其总体病死率，但HCV感染相关病死率增加。

Analysis of liver-related mortality among human immunodeficiency virus infected patients after blood donation who received combined antiretroviral therapy

ObjectiveTo investigate the effect of combined antiretroviral therapy (cART) on liver-related mortality among human immunodeficiency virus (HIV)-infected patients after blood donation. MethodsFrom January 2003 to December 2015, gender, age, diagnosis point, treatment status, date of death, main causes of death and other information of 940 patients with acquired immunodeficiency syndrome (AIDS) were collected. The factors influencing the related death of liver disease of 638 patients with cART (cART treated group) and 302 untreated patients (untreated group) were analyzed, retrospectively. ResultsThe overall mortality of patients in cART treated group was 33.9% (216/638), which was significantly lower than that in untreated group (93.4%, 282/302), with significant difference (χ² = 291.511, P < 0.001). However, the mortality of liver disease of patients in cART group was 7.8% (50/638), significantly higher than that in untreated group (4.0%, 12/302), with significant difference (χ² = 4.966, P = 0.026). The mortality and fatality rates of hepatitis C virus infection of patients in cART group were 7.1% (45/638) and 20.8% (45/216), which were significantly higher than those in untreated group 2.6% (8/302) and 2.8% (8/282)], with significant differences (χ² = 7.473, P = 0.006; χ² = 41.655, P < 0.001). ConclusionsIn previous HIV-infected people, cART could reduce the overall case-fatality rate, but the mortality associated with HCV infection increased.