HBV和/或HCV协同感染与接受HAART治疗HIV/AIDS患者肝损害之间的关系研究

Study on relation between HBV and/or HCV co-infection and liver damage in 71 HIV/AIDS patients receiving highly active anti-retroviral therapy (HAART)

目的探讨接受HAART治疗的HIV/AIDS患者肝损害的相关危险因素。方法收集接受HAART治疗的71例HIV/AIDS患者病例资料,比较两组患者的年龄、性别、感染途径、饮酒状况、CD4+T细胞数、HAART治疗方案、肝毒性药物的使用、HBV和/或HCV协同感染等对肝功能的影响。结果71例患者中HBV感染者9例,HCV感染者35例,其中HBV、HCV共同感染者5例;51例患者出现了肝功能异常。肝功能异常组与肝功能正常组HBV和/或HCV协同感染比率分别为63%和35%,差异有统计学意义(P=0.035),年龄、性别、感染途径、饮酒状况、CD4+T淋巴细胞数(<50)、HAART治疗方案、使用肝毒性药物的比率差异无统计学意义(P>0.05)。Logist回归分析HBV和/或HCV的协同感染是HAART患者肝功能损伤的危险因素。结论HBV和/或HCV与HIV的协同感染十分普遍,是HAART治疗HIV/AIDS患者肝功能损伤的重要危险因素。

Objective To study the risk factors of liver damage in 71 HIV/AIDS patients receiving highly active anti-retroviral therapy（HAART）. Methods Seventy one HIV-1 infected patients receiving HAART, 48 males and 23 females, aged 9-67 years, averaged 38.41 ± 10. 5 years, were retrospectively studied. Relations between age, gender, routes of transmission, alcohol abuse, CD4^＋T lymphoctytes counts, HAART regimens, liver toxic drugs exposures and the liver damage were analyzed, respectively. Results Nine （12.7%） patients were co-infected with HBV, 35 （50%） with HCV, 5 （7%） with HBV and/or HCV. The rate of HBV and/or HCV co-infection was significantly higher in patients with elevated liver enzymes compared to those without elevated liver enzymes（63% vs 35%, P=0. 035）. No statistical differences were found in relations between age, gender, routes of transmission, alcohol abuse, CD4^＋T cell counts, HAART regimens, respectively, and liver damage with and without elevated liver enzymes. Logistic analysis showed that HBV and/or HCV co-infection was a risk factor of liver damage in HIV-infected patients receiving HAART. Conclusion HBV and/or HCV co-infection is common in HIV-infected people, and is a very important risk factor of liver damage in HIV/AIDS patients receiving HAART.