摘要
目的了解合并乙型肝炎病毒(HBV)感染及其基因亚型对艾滋病病毒1型(HIV-1)病人抗病毒药物治疗疗效的影响。方法采用实时荧光定量聚合酶链反应(PCR)检测HBV基因型,根据分型情况进行组内比较。调查病人纳入治疗组时和进行抗病毒治疗(ART)6个月、12个月、24个月以及36个月后各项临床指标。结果共收集46份HIV-1、HBV合并感染病人的标本,以50份单独感染HIV-1病人的标本作为对照。46例共感染病人中,共检出30例B基因型,其余为非B基因型。每组病人经过治疗后,CD4细胞计数值均明显上升,肝脏生化酶指标均明显下降。比较B型与非B型病人的肝、肾功能指标,在治疗前期差异有统计学意义;但其他病毒学应答在ART治疗6个月、12个月、24个月以及36个月时,差异无统计学意义,比较单独感染HIV-1和HIV-1/HBV合并感染病人在治疗过程中的血小板变化,治疗6个月时的血肌酐,以及治疗12个月时的血红蛋白值,差异有统计学意义,其他病毒学应答无统计学意义。结论 ART治疗可明显提升共感染病人的免疫水平,促进丙氨酸转氨酶(ALT)和天冬氨酸转氨酶(AST)恢复正常,使病人病情好转。是否感染HBV和所感染HBV的基因型,在短期内可能影响到HIV-1病人的部分临床应答,但这种影响会随着治疗的深入而逐渐消失。
Objective To better understand the relationship between the effect of antiretroviral therapy for HIV patients and hepatitis B virus (HBV) infection and its genotypes in Hunan Province. Methods Samples were amplified by real-time PCR for HBV genotype analysis and then compared with different genotypes. Clinical symptoms were investigated at baseline and after the treatment for 6,12,24 and 36 months. Results A total of 46 plasma samples were obtained from HIV-1/HBV co-infected individuals and 50 plasma samples were obtained from HIV-1 patients as controls. HBV was identified as B and non B subtype. CD4 T cell counts increased rapidly and liver enzymes dropped obviously in two groups. There were significant differences in liver enzymes and serum creatinine values among the different HBV subtypes in early course of treatment, but no difference was found in other virological responses after treatment for 6,12,24 and 36 months. For co- and single infected patients, significant differences were found only in hematoblastic counts, serum creatinine and haemoglobin values. Conclusion Antiretroviral therapy(ART) could build up immunity function and promote ALT and AST to return to normal for HBV/HIV co-infected patients. In the early stage, part of virological response may be affected by co-infection and HBV genotypes for HIV-1 patients, but the impact would disappear graduallv.
出处
《中国艾滋病性病》
CAS
2012年第8期504-507,520,共5页
Chinese Journal of Aids & STD
基金
全球基金艾滋病综合防治项目(项目编号:CHN-304-G03-H)~~