艾滋病合并丙型肝炎抗病毒治疗中肝损害的相关因素

Correlation factors for hepatic lesion in HIV and HCV coinfected patients during the course of antiretroviral therapy

由于传播途径和易感人群相似，HIV合并HCV感染相当常见。HAART虽然改善了患者的寿命和预后，但在HIV合并HCV感染者中长期的用药会使得肝损害的发生率增加，不仅导致治疗费用支出增多，还妨碍了对HIV的长期抑制作用。目前对于HIV合并HCV感染者HAART过程中肝损害的机制了解不多，此文对可能的损害因素，包括HIV／HCV合并感染的双重影响、HAART引起的免疫重建、抗病毒药物的肝毒性、肝脏相关的超敏反应、合并其他机会性感染及酒精暴露等进行综述。合理有效的HAART和抗HCV治疗，可减缓HAAT过程中肝损害的发生。

HIV/HCV coinfection is very common because both have similar transmission routes and susceptible population. Although highly active antiretroviral therapy （HAART） has greatly improved the longevity and prognosis of HIV/AIDS patients, the morbidity of hepatic lesion in patients coinfected with HIV and HCV increases after long-term HAART, not only leading to the growth in medical expenditure but also hindering the long-term suppression effects on HIV. As the mechanism of hepatic lesion during the course of HAART in patients with HIV/HCV coinfection is still obscure, the correlation factors about hepatic lesion such as HIV/HCV coinfection, immune reconstitution after HAART, hepatotoxicity caused by antiviral drugs, hver-related supersensitivity, complication with other opportunistic infection, and exposure to alcohol are reviewed in the article. The reasonable and effective therapy regimen against HIV and HCV eou/d decrease the incidence rate of hepatic lesion during the course of HAART.