HIV/HCV合并感染者的生物学特征与生存分析

Biological characteristics and survival analysis in HIV/HCV co-infected patients

目的：了解HIV／HCV合并感染者、单纯HIV感染者的肝脏受损状况、肝脏功能指标以及生存状况。方法：对河南省某地有偿献血所致的HIV／HCV合并感染组144人和单纯HIV感染组60人进行回顾性队列研究，记录其生存情况，进行CD4＋和CD8＋T淋巴细胞计数以及肝功能各项指标检查，B超检查肝脏纤维化情况。结果：HIV／HCV合并感染组的生存时间为21．998（20．960—23．036）a，单纯HIV感染组的生存时间为24．904（23．555～26．253）a，两组生存曲线差异具有统计学意义（x2=6．183，P=0．013）。两组CD4＋、CD8＋T淋巴细胞计数差异无统计学意义（Z=1．019和0．121，P〉0．05）。HIV／HCV合并感染组的肝脏纤维化率以及ALT、AST、PT异常升高的比例高于单纯HIV感染组（x2=6．410、4．123、4．312和4．040，P〈0．05）。结论：HIV可以促进HIV／HCV合并感者肝脏的纤维化进程。

Aim： To analyse liver damage situation,biochemical parameters and survival condition of HIV / HCV coinfected people and only HIV infected people. Methods： A total of 144 patients in HIV / HCV co-infection group and 60 patients in HIV infection group who were paid blood donors in Henan Province were studied through retrospective cohorts and followed-up for survival quality. The blood samples were collected for determining CD4＋,CD8＋T cell counts and biochemical parameters,and ultrasonic examination was performed for liver fibrosis detection. Results： The survival time of HIV /HCV co-infected people was 21. 998（ 20. 960- 23. 036） years,and the survival time of HIV infected people was 24. 904（ 23. 555- 26. 253） years,and there was statistical difference between the two groups（ χ2= 6. 183,P = 0. 013）. After HAART,the CD4＋and CD8＋T cell counts between the 2 groups had no significant difference（ Z = 1. 019,0. 121, P〈0. 05）. However,the incidence of liver fibrosis and the levels of ALT,AST,TP in HIV / HCV co-infection group was higher than those of HIV infection group（ χ2= 6. 410,4. 123,4. 312,4. 040, P〈0. 05）. Conclusion： Compared with single HIV infected people,HIV / HCV co-infection might accelerate the progression of the liver fibrosis.