HCV—RNA水平对HIV／HCV合并感染者HIV疾病进展影响研究

Impact of HCV-RNA levels on HIV-1 disease progression in Chinese HIV/HCV co-infected individuals

目的探讨人免疫缺陷病毒（HIV）和丙型肝炎病毒（HCV）混合感染者HCV—RNA水平对HIV感染疾病进展的影响。方法采用横断面研究对391例不同途径HIV感染者进行抗HCV—IgG、HCV—RNA、HIV—RNA、T淋巴细胞计数及其他免疫活化指标检测，比较HCV—RNA水平高组和低组病毒学及免疫学相关指标差别，分析HCV—RNA与HIV—RNA、CD4^＋T淋巴细胞计数的相关性。结果（1）有偿供血组（93％）和静脉吸毒组（97．5％）抗HCV-IgG阳性率显著高于性接触组（20．1％）；在抗HCV—IgG阳性的HIV感染者中，静脉吸毒组HCV—RNA阳性率（89．9％）显著高于有偿供血组（48．3％）及性接触组（62．5％），P均〈0．01。（2）HCV—RNA水平和HIV—RNA水平正相关（r=0．237，P〈0．01），与CD4计数负相关（r=-0．201，P〈0．05）。（3）HCV—RNA高组免疫活化标志物HLA—DR表达高于HCV—RNA低组（P〈0．01）。结论高水平的HCV—RNA可能是HIV感染疾病进展的危险因素之一。

Objective To investigate the impact of hepatitis C virus （HCV）-RNA levels on human immunodeficiency virus （HIV）-1 disease progression in Chinese HIV/HCV co-infected individuals. Methods Cross-sectional analysis was performed among 391 HIV-infected patients for assessment of HCVIgG, HCV-RNA, HIV-RNA, CD4 cell counts and cell surface markers of immune activation, to compare the difference of viral and immune indexes between HCV-RNA high group and HCV-RNA low group, and to elucidate the association between HCV-RNA, HIV-RNA and CD4 cell counts in HIV/HCV co-infected patients. Results （1） The percentage of anti HCV-IgG positive of former plasma donor group （93%） and drug-injection group （97.5%） were significantly higher than that of sexual transmission group （20. 1% ）. The percentage of HCV-RNA positive of drug-injection group （89.9%） was significantly higher than that of former plasma donor group （48.3%） and sexual transmission group （62.5%）, P 〈 0.01, respectively. （2） HCV-RNA levels were positively correlated to HIV-RNA levels （ r = 0. 237, P 〈 0.01 ） , whereas were negatively correlated to CIM cell counts （r = -0.201, P 〈 0.05 ）. （3）The HLA-DR expression on T lymphocytes of HCV-RNA low group was lower than that of HCV-RNA high group （P 〈 0.01 ）. Conclusion High level HCV-RNA may act as a risk factor of HIV-1 disease progression.