大理市HIV感染者中HCV感染状况的研究

Investigation of HCV co-infection among HIV-1 infected patients in Dali city

目的探讨人类免疫缺陷病毒(HIV)-1感染者中丙型肝炎病毒(HCV)的混合感染率,并了解HCV对HIV-1感染者CD4+T细胞计数的影响。方法采用横断面研究方法,在云南大理市招募HIV-1感染者,分别采用血清学和核酸方法检测HCV混合感染。结果在526例HIV-1感染者中,静脉吸毒者占94.3%,其余为性途径感染。86.9%(457/526)为HCV血清学检测抗体阳性,其中HCV核酸阳性者占78.3%。在HCV血清学阴性的69例中,24例HCV RNA>1 000 IU/mL。由于引入HCV核酸检测方法,现场HCV混合感染的发现率增加了4.6%(24/526),所调查的HIV-1感染者中HCV混合感染率为91.4%。HCV混合感染者的CD4+T细胞计数明显低于HIV-1单纯感染者。结论在HCV感染的高流行区或髙危人群中,HCV与HIV-1共感染率较高。筛查HIV-1感染时应加强对HCV的检测,有助于对HCV感染进行早期诊断并开展HCV的早期治疗,减少HCV对HIV-1感染者的不利影响。

Objective To investigate the ratio of hepatitis C virus（HCV） co-infection and the impact of HCV co-infection on CD4＋T cell counts in human immunodeficiency virus 1（HIV-1）-infected patients.Methods A cross-sectional study was performed among HIV-1-infected patients for assessment of HCV co-infection determination with serology and nucleic acid test in Dali Yunnan.Results Among 526 HIV-1-infected patients,the injecting drug users accounted for 94.3%,and the others were infected through sex.The percentage of anti HCV-IgG positive was 86.9%（457/526）,and the positive accordant rate of HCV RNA and anti HCV-IgG was 78.3%.However,HCV RNA 1 000 IU/mL was detected in 24 patients out of 69 anti HCV-IgG negative patients.As for HCV nucleic acid test,the detection rate of HCV co-infection increased 4.6%（24/526）.The ratio of HCV co-infection was 91.4%.The CD4＋ T cell counts among single HIV-1 infection were significantly higher than those among HCV co-infection.Conclusions The ratio of HIV-1/HCV infection is high in high-risk areas or population,and the determination of HCV during screening HIV-1 infection may help for the early diagnosis and treatment of HCV and decrease the effect of HIV-1 infection patients.