HIV/HCV共感染患者肝损害影响因素的研究

Risk factors for liver injury in patients with HIV and HCV coinfection

目的:探讨HIV/HCV共感染患者肝损害影响因素。方法:回顾性分析92例HIV/HCV共感染患者,男51例(55.4%),女41例(44.6%)。年龄9～62岁,平均(39.5±9.4)岁。分别采用单因素及Logistic回归方法分析其肝损害影响因素。结果:单因素分析发现肝损害组20例(33.9%)有抗结核治疗史,39例(66.1%)有抗逆转录病毒治疗史,37例(62.7%)CD4+T淋巴细胞计数<200个/mm3;无肝损害组患者4例(12.1%)有抗结核治疗史,13例(39.4%)有抗逆转录病毒治疗史,14例(42.4%)CD4+T淋巴细胞计数<200个/mm3,统计学分析差异有显著性(P值分别等于0.023、0.013、0.031)。Logistic回归分析提示抗结核治疗和抗逆转录病毒治疗是HIV/HCV共感染患者肝损害的危险因素。结论:HIV/HCV共感染患者肝损害的影响因素是多方面的,其中抗结核治疗和抗逆转录病毒治疗是其独立危险因素。

Objective To explore the risk factors for liver injury in patients with HIV and HCV coinfection. Methods 92 HIV/HCV coinfected patients [51 males and 41 females; aged 9-62 years, mean （39.5 ± 9.4）years] were retrospectively reviewed. The risk factors for liver injury were analyzed by single-variant analysis and multivariant analysis. Results In the group with liver injury, 20 patients （33.9%） had a history of antituberculous therapy, 39 （66.1%） had a history of antiretroviral treatment, and 37 （62.7%） had a CD4 count lower than 200/mm^3; while 4 patients （6.8%） had a history of antitubereulous therapy, 13 （22.0%） had a history of antiretroviral treatment, and 14 （22.7%） had a CD4 count lower than 200/mm^3 in the group without liver injury. The differences between the two groups were significant （P = 0.023, 0.013, and 0.031; respectively）. Logistic regression analysis revealed that antituberculous therapy or antiretroviral therapy was an independent risk factor for liver injury in HIV/HCV coinfected patients. Conclusions Of the multiple factors associated with liver injury in patients with HIV and HCV coinfection, antitubercoulous or antiretroviral therapy is an independent risk factor.