河北省HIV-1感染者中HCV和TP合并感染及免疫状态分析

Analysis on HCV and TP co-infection and immune state among HIV-1 infected people in Hebei Province

目的了解河北省艾滋病病毒(human immunodeficiency virus,HIV)感染者中,丙型肝炎病毒(hepati-tis C virus,HCV)、梅毒螺旋体(Treponema pallidun,TP)的感染情况以及免疫状态。方法采集HIV-1感染者的抗凝全血样品。采用酶联免疫吸附试验(enzyme-linked immunosorbent assay,ELISA)和蛋白免疫印迹试验(western blot-ting)检测HCV抗体,采用梅毒快速血浆反应素试验和梅毒螺旋体颗粒凝集试验检测梅毒的感染状况,并使用流式细胞仪测定CD4+T细胞。结果 136例HIV-1感染者中HCV感染率为19.1%(26/136),TP感染率为14.7%(20/136),HIV/HCV/TP混合感染率为2.2%(3/136)。不同传播途径HIV-1感染者的HCV感染率差异有统计学意义(P<0.001),6例注射吸毒者全部感染HCV,感染率为100.0%;其次是血液途径传播,感染率为78.6%。不同性别、年龄、婚姻状态和文化程度HIV-1感染者的HCV感染率差异均有统计学意义(均有P<0.05)。不同性别HIV-1感染者的TP感染率间差异有统计学意义(2=5.28,P=0.022)。HIV-1感染者中,HCV抗体阳性者CD4+T细胞计数低于抗体阴性者,差异有统计学意义(Z=2.53,P=0.011)。结论 HIV-1感染人群中,有较高的HCV和TP感染率,而且HIV/HCV合并感染时会影响CD4+T细胞计数。

Objective To study the ratios of hepatitis C virus （HCV） and Treponema pallidun （TP） co-infection and immune state among HIV-1 infected people in Hebei Province. Methods Peripherial blood was collected for testing HCV antibody with enzyme-linked immunosorbent assay （ELISA） and western blotting assay, TP antibody with rapid plas- ma reagin （RPR）and Treponema pallidun particle agglutination assay （TPPA） and CD4＋ T cell count by flow cytometry in the HIV-1 infected individuals. Results Of the 136 HIV-1 infected individuals who were investigated with blood tests, 19.1% （26/136） were infected with HCV, 14.7% （20/136） were infected with TP, 2.2% （3/136） were co-infected with HCV/TP. The statistic analysis showed a significant difference in the ratios of HCV co-infection between individuals who were infected with HIV through different routes （P〈0.001）. The ratios of HCV co-infection were the highest （6/6）in injecting drug users. Comparing by ratio of HCV co-infection, statistical significant difference were found between gender, age, marriage and education degree. The statistic analysis showed a significant difference in the ratios of TP co-infection between gender （x2 =5.28,P=0.022）. CD4＋ T cell accounts in HIV infected people with HCV co-infection were significantly lower than in those who were only infected with HIV. Conclusions There are higher ratios of HCV and TP co-infection in HIV-1 infected individuals. HCV co-infection has effects on CD4＋ T cell accounts in HIV infected peoples.